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NPI Code Detail

MEDICARE: DOROTHEA REBEKKA WEISFLOG MS., BCBA, LBA

MEDICARE: DOROTHEA REBEKKA WEISFLOG MS., 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
1103K00000XBehavior AnalystL-508LA

General Provider Information

NPI Number : 1689267866
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHEA REBEKKA WEISFLOG MS., BCBA, LBA
Provider Business Mailing Address
First Line : PO BOX 66558
Second Line :
City : BATON ROUGE
State : LA
Zip : 70896-6558
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 422 COLONIAL DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6505
Country : US
Telephone Number : 225-922-0644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2021
Last Update Date : 01/08/2026

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