Provider Demographics
NPI:1235995747
Name:WEIRETER, ASHLEY ANNE (BCBA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANNE
Last Name:WEIRETER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ANNE
Other - Last Name:RANDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:80 PINE DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-2509
Mailing Address - Country:US
Mailing Address - Phone:914-393-0606
Mailing Address - Fax:
Practice Address - Street 1:80 PINE DR
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-2509
Practice Address - Country:US
Practice Address - Phone:914-393-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-24-70554103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty