Individual
MARY AULTMAN WELDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, LBA
Contact information
Practice address
402 LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
Mailing address
1412 FONTAINE DR, JACKSON, MS 39211-5618
(403) 326-3478
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
200052
MS
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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