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General NPI Number Information
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NPI Number | 1023349073
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Entity Type | Individual
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Provider Name | SUSAN ELAINE WEBER PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 323 ZACHARY TAYLOR HWY
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City | FLINT HILL
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State | VA
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Zip | 22627-1867
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Country | US
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Telephone | 540-671-3563
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Fax | 703-783-0099
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Provider Business Mailing Address
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Address Line | PO BOX 333
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City | FLINT HILL
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State | VA
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Zip | 22627-0333
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Country | US
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Telephone | 540-671-3563
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Fax | 703-783-0099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 0810004774
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810004774
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License Number State | VA
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