Provider Demographics
NPI:1023473816
Name:DUNCANS, NICHELLE JANINE (BCBA)
Entity type:Individual
Prefix:
First Name:NICHELLE
Middle Name:JANINE
Last Name:DUNCANS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 SE 139TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-1849
Mailing Address - Country:US
Mailing Address - Phone:360-720-3042
Mailing Address - Fax:
Practice Address - Street 1:327 SE 139TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-1849
Practice Address - Country:US
Practice Address - Phone:360-720-3042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORABA-AB-10231747106E00000X
ORABA-B-10242112103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst