Provider Demographics
NPI:1386323400
Name:MONFORD, VERONCIA (MED, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:VERONCIA
Middle Name:
Last Name:MONFORD
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 KANATAK LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-5102
Mailing Address - Country:US
Mailing Address - Phone:734-883-1322
Mailing Address - Fax:
Practice Address - Street 1:839 KANATAK LN
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-5102
Practice Address - Country:US
Practice Address - Phone:734-883-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLBA0000001184103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst