Provider Demographics
NPI:1962916338
Name:PARUCHURI, VINEELA (BCBA)
Entity type:Individual
Prefix:
First Name:VINEELA
Middle Name:
Last Name:PARUCHURI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2086
Mailing Address - Country:US
Mailing Address - Phone:218-724-3122
Mailing Address - Fax:833-933-0639
Practice Address - Street 1:5215 EDINA INDUSTRIAL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2926
Practice Address - Country:US
Practice Address - Phone:612-594-8405
Practice Address - Fax:855-586-2494
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician