Provider Demographics
NPI:1891024634
Name:WELTERLIN, AURELIE (PSYD, BCBA-D)
Entity type:Individual
Prefix:
First Name:AURELIE
Middle Name:
Last Name:WELTERLIN
Suffix:
Gender:F
Credentials:PSYD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 YORKTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-3454
Mailing Address - Country:US
Mailing Address - Phone:919-213-9845
Mailing Address - Fax:
Practice Address - Street 1:1100 NW MAYNARD RD STE 140
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8707
Practice Address - Country:US
Practice Address - Phone:919-428-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2013-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102873103TC0700X
NJ1084238103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst