MEDICARE: DR. ALLISON WEISER PSYD

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
1	103TC0700X	Clinical Psychologist	PY10633	FL

General Provider Information

NPI Number	:	1912599549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLISON WEISER PSYD

Provider Business Mailing Address
First Line	:	4400 N CONGRESS AVE STE 100
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3221
Country	:	US
Telephone Number	:	561-247-0731
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 N CONGRESS AVE STE 100
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3221
Country	:	US
Telephone Number	:	561-247-0731
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2021
Last Update Date	:	09/13/2021

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