Nichole Elizabeth Ruddell, MS, BCBA
Behavior Analyst in Peoria, IL. Individual provider (NPI-1).
NPI number1235722299
StatusActive
Last updated in NPPESFeb 19, 2021
Details
- NPI
- 1235722299
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Nichole Elizabeth Ruddell
- Credential
- MS, BCBA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 19, 2021
- Certification date
- Feb 19, 2021
- Last updated
- Feb 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-21-47684 | – | Yes |
Practice location
507 E Armstrong AvePeoria, IL 61603-3201
Phone 309-686-1177
Mailing address
507 E Armstrong AvePeoria, IL 61603-3201
Phone 309-686-1177
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