Provider Demographics
NPI:1962164491
Name:WEINLAEDER, ASHLEY ELAINE (MED, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ELAINE
Last Name:WEINLAEDER
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:ELAINE
Other - Last Name:LAFRENIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:15910 71ST ST NE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-8814
Mailing Address - Country:US
Mailing Address - Phone:701-360-2509
Mailing Address - Fax:
Practice Address - Street 1:15910 71ST ST NE
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-8814
Practice Address - Country:US
Practice Address - Phone:701-352-4392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDL90103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst