Individual
TAYLOR NICOLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBS
Contact information
Practice address
10501 DRUMMOND RD, PHILADELPHIA, PA 19154-3807
(215) 613-1000
Mailing address
3130 LEVICK ST, PHILADELPHIA, PA 19149-3136
(267) 549-5085
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH006567
PA
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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