MEDICARE: VIRGINIA VECCHIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	16-24288	FL
2	103K00000X	Behavior Analyst	1-20-41154	FL
3	106E00000X	Assistant Behavior Analyst	0-18-9160	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336656784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA VECCHIO

Provider Business Mailing Address
First Line	:	9410 DUGAS DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78245-1869
Country	:	US
Telephone Number	:	210-447-7041
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 LADD ST BLDG 3850
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78236-5308
Country	:	US
Telephone Number	:	210-447-7041
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2018
Last Update Date	:	05/20/2024

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Directions to “ VIRGINIA VECCHIO ” Practice Location

Language	Start Address	Practice Location

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