Provider Demographics
NPI:1336816685
Name:WEIMER, AUDREE (RBT)
Entity type:Individual
Prefix:
First Name:AUDREE
Middle Name:
Last Name:WEIMER
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47302-3433
Mailing Address - Country:US
Mailing Address - Phone:765-591-7169
Mailing Address - Fax:
Practice Address - Street 1:425 E 8TH ST
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47302-3433
Practice Address - Country:US
Practice Address - Phone:765-591-7169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-24-344966106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician