Provider Demographics
NPI:1760809032
Name:WILLIAMS, NICHOLE (PHD, BCBA, COBA)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD, BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1133
Mailing Address - Country:US
Mailing Address - Phone:419-303-9641
Mailing Address - Fax:
Practice Address - Street 1:76 S HIGH ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1133
Practice Address - Country:US
Practice Address - Phone:614-963-2956
Practice Address - Fax:614-634-0402
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty