Most Relevant Information
Provider Data
| NPI Number: | 1003585977 |
| Provider Name: | NICOLE MAEDA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/13/2021 |
| Last Updated: | 05/27/2022 |
Provider Practice Location
910 ROOSEVELT RD
GLEN ELLYN
IL
601377829
Practice Location Phone/Fax
| Phone: | 6305800853 |
| Fax: |
Provider Mailing Location
910 ROOSEVELT RD
GLEN ELLYN
IL
601377829
Provider Mailing Phone/Fax
| Phone: | 6305800853 |
| Fax: |