Healthcare Provider Details

I. General information

NPI: 1730662008
Provider Name (Legal Business Name): ALEJANDRA WEISS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 MADISON RD STE B
CINCINNATI OH
45227-1426
US

IV. Provider business mailing address

4760 MADISON RD STE B
CINCINNATI OH
45227-1426
US

V. Phone/Fax

Practice location:
  • Phone: 614-636-0746
  • Fax:
Mailing address:
  • Phone: 614-636-0746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM.2400319
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number29279
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: