Individual
KIMBERLY NICHOLS-GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
190 W RIPPLE AVE, OSHKOSH, WI 54902-7369
(920) 642-9716
Mailing address
190 W RIPPLE AVE, OSHKOSH, WI 54902-7369
(920) 642-9716
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
414-140
WI
Other
Enumeration date
03/18/2021
Last updated
10/11/2024
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