Provider Demographics
NPI:1205320728
Name:WEINERT, ASHLEY L (LLP, NCSP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:WEINERT
Suffix:
Gender:F
Credentials:LLP, NCSP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:L
Other - Last Name:MARDEROSIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29642 MACINTOSH LN
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-8912
Mailing Address - Country:US
Mailing Address - Phone:248-921-1832
Mailing Address - Fax:
Practice Address - Street 1:27780 NOVI RD STE 244
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3427
Practice Address - Country:US
Practice Address - Phone:248-916-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool