Provider Demographics
NPI:1205196813
Name:NIELSEN, MAIRI ANN MCALLISTER (BCBA, CADCII)
Entity Type:Individual
Prefix:MRS
First Name:MAIRI
Middle Name:ANN MCALLISTER
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:BCBA, CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-1466
Mailing Address - Country:US
Mailing Address - Phone:541-523-6581
Mailing Address - Fax:541-523-9237
Practice Address - Street 1:3610 MIDWAY DR
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-1466
Practice Address - Country:US
Practice Address - Phone:541-523-6581
Practice Address - Fax:541-523-9237
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health