Healthcare Provider Details
I. General information
NPI: 1124742622
Provider Name (Legal Business Name): NICOLYN BILYEU MA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/28/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2532 SANTIAM HWY SE # 114
ALBANY OR
97322-5211
US
IV. Provider business mailing address
2532 SANTIAM HWY SE # 114
ALBANY OR
97322-5211
US
V. Phone/Fax
- Phone: 541-451-0139
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | ABA-B-10244079 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: