Nicole Leann Householder, RBT
Behavior Technician in Milton, FL. Individual provider (NPI-1).
NPI number1962097170
StatusActive
Last updated in NPPESMar 9, 2021
Details
- NPI
- 1962097170
- Entity type
- Individual (NPI-1)
- Name
- Nicole Leann Householder
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 9, 2021
- Certification date
- Mar 9, 2021
- Last updated
- Mar 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-21-159268 | – | Yes |
Other names
- Nicole Leann Devlin (Former Name)
Practice location
6810 Fort Jackson CtMilton, FL 32583-7692
Phone 850-503-6636 · Fax 850-626-6132
Mailing address
6810 Fort Jackson CtMilton, FL 32583-7692
Phone 850-503-6636 · Fax 850-626-6132
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