Provider Demographics
NPI:1801618517
Name:NOLAN, MEREDITH ANN (BCBA)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANN
Last Name:NOLAN
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 1:194 JULIANN DR APT 2
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-2739
Mailing Address - Country:US
Mailing Address - Phone:630-200-7043
Mailing Address - Fax:
Practice Address - Street 1:820 PARKVIEW BLVD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3200
Practice Address - Country:US
Practice Address - Phone:630-449-3101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst