Provider Demographics
NPI:1215601844
Name:VIVEIROS, NICOLE KATHRYN (MA, BCBA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:KATHRYN
Last Name:VIVEIROS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726-4641
Mailing Address - Country:US
Mailing Address - Phone:508-642-7111
Mailing Address - Fax:
Practice Address - Street 1:1 MERRILLS WHARF
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-7280
Practice Address - Country:US
Practice Address - Phone:508-994-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst