Healthcare Provider Details

I. General information

NPI: 1962079426
Provider Name (Legal Business Name): CARLEE WEIR RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 N 12TH ST
MURRAY KY
42071-1651
US

IV. Provider business mailing address

1321 MURFREESBORO PIKE STE 702
NASHVILLE TN
37217-2679
US

V. Phone/Fax

Practice location:
  • Phone: 270-767-6415
  • Fax: 615-815-1946
Mailing address:
  • Phone: 615-361-4000
  • Fax: 615-815-1946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2024023808
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: