MISS Nicole Justine Tisdale, M.S., B.C.B.A

NPI #1164712758 in Yorba Linda, California

Provider Information

NPI Number: 1164712758
Entity Type: Individual
Name: MISS Nicole Justine Tisdale, M.S., B.C.B.A
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Credential: M.S., B.C.B.A
Enumeration Date: Apr 15, 2011
Last Updated: Apr 15, 2011

Practice Location

Address: 25600 CROSS CREEK DR
Address 2: 49C
City: Yorba Linda
State: California
ZIP Code: 92887-6238
Phone: (714) 497-5543

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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