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NPI Code Detail

MEDICARE: MARISSA ANN WEILER BCBA, LBA

MEDICARE: MARISSA ANN WEILER BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician5103
2103K00000XBehavior Analyst3994TX

General Provider Information

NPI Number : 1457859332
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA ANN WEILER BCBA, LBA
Provider Business Mailing Address
First Line : PO BOX 33568
Second Line :
City : SAN DIEGO
State : CA
Zip : 92163-3568
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Provider Business Practice Location Address
First Line : 1632 RAIDER WAY
Second Line :
City : LEANDER
State : TX
Zip : 78641-5404
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2018
Last Update Date : 08/12/2025

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Directions to “ MARISSA ANN WEILER BCBA, LBA” Practice Location

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