Most Relevant Information
Provider Data
| NPI Number: | 1003311481 |
| Provider Name: | JADE N NICHOLSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/27/2018 |
| Last Updated: | 03/27/2018 |
Provider Practice Location
1026 CROMWELL BRIDGE RD
TOWSON
MD
212863318
Practice Location Phone/Fax
| Phone: | 4105831515 |
| Fax: |
Provider Mailing Location
1026 CROMWELL BRIDGE RD
BALTIMORE
MD
212863318
Provider Mailing Phone/Fax
| Phone: | 4105831515 |
| Fax: |