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NPI Code Detail

MEDICARE: ARIEL NICKOLE WEDDLE BCABA

MEDICARE:   ARIEL NICKOLE WEDDLE  BCABA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1912523747
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARIEL NICKOLE WEDDLE BCABA
Provider Business Mailing Address
First Line : 1525 TECHNOLOGY DR
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-5974
Country : US
Telephone Number : 757-609-2795
Fax Number : 866-576-0956
Provider Business Practice Location Address
First Line : 1525 TECHNOLOGY DR
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-5974
Country : US
Telephone Number : 757-609-2795
Fax Number : 866-576-0956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2020
Last Update Date : 06/17/2020

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Directions to “ ARIEL NICKOLE WEDDLE BCABA” Practice Location

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