Provider / Organization | NPI | Date Certified |
---|---|---|
BAILEY ALEXIS NICKELL | 1801485024 | 2021-11-21 |
Bailey Alexis Nickell is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1801485024. Registration indicates Bailey Alexis Nickell is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
Entity Type | Individual |
Provider Name | Bailey Alexis Nickell |
Practice Office Address | 4688 ONTARIO MILLS PKWY ONTARIO, CA US |
Practice Office Telephone | 7148341111 |
Mailing Address | 10761 STAMFIELD DR RANCHO CUCAMONGA, CA 917306606 US |
Code | Practice | License No State |
---|---|---|
106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |