Individual
NICOLE JENEATH VEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
1350 W IRVINGTON RD, TUCSON, AZ 85746-4106
(520) 666-7890
Mailing address
3310 N 19TH AVE, PHOENIX, AZ 85015-5701
(855) 772-8847
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-001099
AZ
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-22-57496
BCBA CERTIFICATE
—
05
—
A0003886
—
ID
Enumeration date
07/16/2019
Last updated
03/31/2026
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