Individual
VANESSA R VALDENEGRO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
204 STEWART ST, CARROLLTON, GA 30117-2437
(678) 890-1055
Mailing address
204 STEWART ST, CARROLLTON, GA 30117-2437
(678) 890-1055
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-20912
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-15-20912
APPLIED BEHAVIOR ANALYSIS (ABA)
FL
Enumeration date
01/10/2013
Last updated
10/22/2025
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