Provider Demographics
NPI:1356616973
Name:WEISS-SALINAS, LUNA MORIAH MIA (BCBA, LBA)
Entity type:Individual
Prefix:MISS
First Name:LUNA
Middle Name:MORIAH MIA
Last Name:WEISS-SALINAS
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WILDCAT DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8880
Mailing Address - Country:US
Mailing Address - Phone:859-248-0621
Mailing Address - Fax:
Practice Address - Street 1:408 MICHELLE CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8449
Practice Address - Country:US
Practice Address - Phone:859-940-3510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251S00000X
KY0024103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No251S00000XAgenciesCommunity/Behavioral Health