Nickelis Vincent

NPI #1831696301 in Yucaipa, California

Provider Information

NPI Number: 1831696301
Entity Type: Individual
Name: Nickelis Vincent
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Apr 10, 2018
Last Updated: Apr 10, 2018

Practice Location

Address: 34590 COUNTY LINE RD STE 7
City: Yucaipa
State: California
ZIP Code: 92399-5398
Phone: (909) 795-4255

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X
Behavior Technician	106S00000X	Primary

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