Search › Georgia › 103K00000X
Shane Nichols, BCBA
NPI 1649880493 · on the registry since 2020
Practice
- Address
- 1401 Applewood Dr Ste 2
Dalton, GA 30720 - Phone
- (706) 250-9372
- Fax
- (706) 343-9939
- Organisation at this address
- Kiwiaba Llc
Highlandrivers
Highland Rivers Csb
Highland Rivers CsbInferred from a shared address, not stated in the registry. - Clinicians at this address
- 26
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 103K00000X
103K00000X - Licence states on file
- TN, WY, GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-01-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia