Provider Demographics
NPI:1477944999
Name:RANGEL, NICOLE CHARLOTTE (BCBA)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:CHARLOTTE
Last Name:RANGEL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:CHARLOTTE
Other - Last Name:FROLANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:2400 S INTERSTATE 35 STE 190
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681
Mailing Address - Country:US
Mailing Address - Phone:737-708-8003
Mailing Address - Fax:737-708-8022
Practice Address - Street 1:2400 S INTERSTATE 35 STE 190
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-8015
Practice Address - Country:US
Practice Address - Phone:737-708-8003
Practice Address - Fax:737-708-8022
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4879103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst