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NPI Code Detail

MEDICARE: VINEELA PARUCHURI BCBA

MEDICARE: VINEELA PARUCHURI BCBA
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1962916338
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINEELA PARUCHURI BCBA
Provider Business Mailing Address
First Line : 101 W 2ND ST
Second Line :
City : DULUTH
State : MN
Zip : 55802-2086
Country : US
Telephone Number : 218-724-3122
Fax Number : 833-933-0639
Provider Business Practice Location Address
First Line : 5215 EDINA INDUSTRIAL BLVD STE 200
Second Line :
City : EDINA
State : MN
Zip : 55439-2926
Country : US
Telephone Number : 612-594-8405
Fax Number : 855-586-2494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2017
Last Update Date : 02/20/2023

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Directions to “ VINEELA PARUCHURI BCBA” Practice Location

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