Provider Demographics
NPI:1821594524
Name:VEAZEY, JORDAN (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:VEAZEY
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:221 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-4213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:221 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4213
Practice Address - Country:US
Practice Address - Phone:256-459-5499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst