Provider Demographics
NPI:1457851115
Name:WEIR, OPHELIA (RBT)
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:
Last Name:WEIR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-1433
Mailing Address - Country:US
Mailing Address - Phone:317-520-4748
Mailing Address - Fax:
Practice Address - Street 1:108 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WAYNETOWN
Practice Address - State:IN
Practice Address - Zip Code:47990-8022
Practice Address - Country:US
Practice Address - Phone:765-326-1501
Practice Address - Fax:765-217-7151
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
IN0-23-14383106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician