Healthcare Provider Details

I. General information

NPI: 1841057874
Provider Name (Legal Business Name): VERONICA RUCKER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 E MAIN ST
MULVANE KS
67110-1734
US

IV. Provider business mailing address

512 E MAIN ST
MULVANE KS
67110-1734
US

V. Phone/Fax

Practice location:
  • Phone: 405-339-6252
  • Fax:
Mailing address:
  • Phone: 405-339-6252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: