Individual
NICOLE ROSE PETRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
5760 E OTERO AVE, CENTENNIAL, CO 80112-3064
(914) 419-3783
Mailing address
6577 S DAHLIA CIR, CENTENNIAL, CO 80121-3501
(914) 419-3783
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36971
CO
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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