Kristin Nichols, RBT
Behavior Technician in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1982416640
StatusActive
Last updated in NPPESJan 21, 2025
Details
- NPI
- 1982416640
- Entity type
- Individual (NPI-1)
- Name
- Kristin Nichols
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 21, 2025
- Certification date
- Jan 21, 2025
- Last updated
- Jan 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-23-274339 | IN | Yes |
Practice location
12938 Coldwater RdFort Wayne, IN 46845-9517
Phone 317-815-5501
Mailing address
4125 E Fleming AveFort Wayne, IN 46806-2705
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