Individual
ASHLEY ELIZABETH NUSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
49466 NICHOLETTE, SHELBY TWP, MI 48317-2283
(248) 506-4079
Mailing address
49466 NICHOLETTE, SHELBY TWP, MI 48317-2283
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-31385
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
06/28/2016
Last updated
05/16/2019
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