Mikaela C Nicholls

NPI #1093436925 in Bend, Oregon

Provider Information

NPI Number: 1093436925
Entity Type: Individual
Name: Mikaela C Nicholls
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Sep 8, 2022
Last Updated: Sep 8, 2022

Practice Location

Address: 19800 VILLAGE OFFICE CT STE 104
City: Bend
State: Oregon
ZIP Code: 97702-1813
Phone: (541) 306-3483

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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