Provider Demographics
NPI:1225502289
Name:NICHOLS, BAYLEE SCHUYLENE (RBT)
Entity Type:Individual
Prefix:
First Name:BAYLEE
Middle Name:SCHUYLENE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 BOBBINS RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-6291
Mailing Address - Country:US
Mailing Address - Phone:210-788-1917
Mailing Address - Fax:
Practice Address - Street 1:1402 BOBBINS RDG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-6291
Practice Address - Country:US
Practice Address - Phone:210-788-1917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-13
Last Update Date:2019-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-18-65502106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician