Healthcare Provider Details

I. General information

NPI: 1255246419
Provider Name (Legal Business Name): TRESTIN ROBERT WEIKLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 ELM ST
LONDON OH
43040-8132
US

IV. Provider business mailing address

14040 WEAVER RD
MARYSVILLE OH
43040-8132
US

V. Phone/Fax

Practice location:
  • Phone: 740-852-5700
  • Fax:
Mailing address:
  • Phone: 937-707-9154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: