Individual
ETHAN WEISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 MARQUETTE AVE NW STE 1200, ALBUQUERQUE, NM 87102-5312
(919) 375-0475
Mailing address
500 MARQUETTE AVE NW STE 1200, ALBUQUERQUE, NM 87102-5312
(919) 375-0475
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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