Provider Demographics
NPI:1194392472
Name:MAYER, LOUISE ANN (RBT)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:ANN
Last Name:MAYER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:ANN
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 MILITARY CUTOFF RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-9737
Mailing Address - Country:US
Mailing Address - Phone:910-392-0080
Mailing Address - Fax:910-392-7035
Practice Address - Street 1:500 MILITARY CUTOFF RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-9737
Practice Address - Country:US
Practice Address - Phone:910-392-0080
Practice Address - Fax:910-392-7035
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NCRBT-19-92246106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician