Provider Demographics
NPI:1790591832
Name:VEESER, NICHOLAS A (RBT)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:A
Last Name:VEESER
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 NW 163RD TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1709
Mailing Address - Country:US
Mailing Address - Phone:954-330-3752
Mailing Address - Fax:
Practice Address - Street 1:3832 SW 33RD CT
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-5631
Practice Address - Country:US
Practice Address - Phone:954-947-5061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-309796106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty