Provider Demographics
NPI:1366815565
Name:WEINMANN, RONIT
Entity type:Individual
Prefix:
First Name:RONIT
Middle Name:
Last Name:WEINMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13741 VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1409
Mailing Address - Country:US
Mailing Address - Phone:248-854-0935
Mailing Address - Fax:
Practice Address - Street 1:2615 W 12 MILE RD STE 119
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1627
Practice Address - Country:US
Practice Address - Phone:248-397-4705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MI68010981621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical