Provider Demographics
NPI:1730833021
Name:WEBER, JONATHAN (RBT, PBT-NCCT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:WEBER
Suffix:
Gender:M
Credentials:RBT, PBT-NCCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9531 SOLOSHINE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-6218
Mailing Address - Country:US
Mailing Address - Phone:412-926-9043
Mailing Address - Fax:
Practice Address - Street 1:2821 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4427
Practice Address - Country:US
Practice Address - Phone:702-840-1182
Practice Address - Fax:702-436-2593
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-21-176585106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician