Provider Demographics
NPI: | 1962683730 |
---|---|
Name: | JOKER SCHAMA, VERONICA (MA, BCBA, LBA) |
Entity type: | Individual |
Prefix: | MS |
First Name: | VERONICA |
Middle Name: | |
Last Name: | JOKER SCHAMA |
Suffix: | |
Gender: | F |
Credentials: | MA, BCBA, LBA |
Other - Prefix: | |
Other - First Name: | VERONICA |
Other - Middle Name: | |
Other - Last Name: | JOKER SCHAMA |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | MA, BCBA, LBA |
Mailing Address - Street 1: | 1200 W SOUTH BOULDER RD STE 204 |
Mailing Address - Street 2: | |
Mailing Address - City: | LAFAYETTE |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80026-2833 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 720-837-2348 |
Mailing Address - Fax: | 303-554-5657 |
Practice Address - Street 1: | 1200 W SOUTH BOULDER RD STE 204 |
Practice Address - Street 2: | |
Practice Address - City: | LAFAYETTE |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80026-2833 |
Practice Address - Country: | US |
Practice Address - Phone: | 720-837-2348 |
Practice Address - Fax: | 303-554-5657 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-11-20 |
Last Update Date: | 2021-03-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
225500000X | ||
TN | 1-00-0135 | 103K00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
No | 225500000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist |