Individual
JACKIE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1599 TOWNSHIP LINE RD, PLAINFIELD, IN 46168-7517
(317) 914-3176
Mailing address
1599 TOWNSHIP LINE RD, PLAINFIELD, IN 46168-7517
(317) 914-3176
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-61749
IN
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/06/2019
Last updated
12/08/2022
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