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NPI Code Detail

MEDICARE: STACEY WEBER

MEDICARE:   STACEY  WEBER
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
1103TS0200XSchool PsychologistOH1200043OH

General Provider Information

NPI Number : 1841670288
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY WEBER
Provider Business Mailing Address
First Line : 32600 WINTERGREEN DR
Second Line :
City : SOLON
State : OH
Zip : 44139-1358
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2323 WRENFORD RD
Second Line :
City : UNIVERSITY HTS
State : OH
Zip : 44118-3902
Country : US
Telephone Number : 216-320-4514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2015
Last Update Date : 06/01/2015

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Directions to “ STACEY WEBER ” Practice Location

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