Individual
MRS. CANDISS NICHOLE DIEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
664 POWERS AVE, ANNISTON, AL 36205-4419
(256) 847-5942
Mailing address
5451 ABLE CT, MOBILE, AL 36693-3100
(251) 410-0160
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2018-042
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-29540
BEHAVIOR ANALYST CERTIFICATION BOARD
—
01
—
14647243
CAQH
—
01
—
2018-042
ALABAMA BEHAVIOR ANALYST LICENSURE BOARD
AL
Enumeration date
03/08/2018
Last updated
04/03/2020
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