Individual
COURTNEY KATHLEEN NISSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA, LBS
Contact information
Practice address
7540 ALLENTOWN BLVD STE 5, HARRISBURG, PA 17112-4238
(717) 649-6085
Mailing address
349 KELLY AVE, MOUNT JOY, PA 17552-9018
(717) 203-2445
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH005034
PA
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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