Provider Demographics
NPI:1720696081
Name:D'AMICO, VERONICA (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:D'AMICO
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 SHOEMAKER RD STE 230
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4238
Mailing Address - Country:US
Mailing Address - Phone:484-681-2170
Mailing Address - Fax:484-320-8307
Practice Address - Street 1:1012 COLLEGE RD STE 103
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-6506
Practice Address - Country:US
Practice Address - Phone:302-747-5747
Practice Address - Fax:484-320-8307
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1-20-42617103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst