Provider Demographics
NPI:1588201792
Name:DOTE, NICHOLE (BCBA)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:DOTE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:MUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7014 YORKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1870
Mailing Address - Country:US
Mailing Address - Phone:847-732-8446
Mailing Address - Fax:
Practice Address - Street 1:14421 S WALLIN DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2502
Practice Address - Country:US
Practice Address - Phone:630-402-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-17-26969103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst