Provider Demographics
NPI:1013432384
Name:RAINES, VERONICA E (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:E
Last Name:RAINES
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12559 WARDS RD
Mailing Address - Street 2:
Mailing Address - City:MACHIPONGO
Mailing Address - State:VA
Mailing Address - Zip Code:23405-2027
Mailing Address - Country:US
Mailing Address - Phone:804-892-5503
Mailing Address - Fax:
Practice Address - Street 1:12559 WARDS RD
Practice Address - Street 2:
Practice Address - City:MACHIPONGO
Practice Address - State:VA
Practice Address - Zip Code:23405-2027
Practice Address - Country:US
Practice Address - Phone:804-892-5503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000996103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-17-25981OtherBEHAVIOR ANALYST CERTIFICATION BOARD