Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marissa Rose Van de Weg

Individual provider Behavior Technician · NPI 1730075656

Marissa Rose Van de Weg is a Behavior Technician in Fort Wayne, Indiana. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

201 E Rudisill Blvd Ste 100B
Fort Wayne, IN 46806-1756
Phone: (260) 255-3665
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1730075656
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 16, 2025
Last updated in NPPESJune 16, 2025
Certification dateJune 16, 2025
Mailing address11510 N 400 W, Decatur, IN 46733-9789

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