Provider Demographics
NPI:1063097293
Name:WEBER, MARSHALL JOHN (RBT)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:JOHN
Last Name:WEBER
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 ACCEPTANCE WAY
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711
Mailing Address - Country:US
Mailing Address - Phone:352-223-1999
Mailing Address - Fax:352-600-3119
Practice Address - Street 1:350 ACCEPTANCE WAY
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3471
Practice Address - Country:US
Practice Address - Phone:352-223-1999
Practice Address - Fax:352-600-3119
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst