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General NPI Number Information
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NPI Number | 1316126782
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Entity Type | Organization
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Legal Business Name | WEIL PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 764 KNOLLS CT
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2741
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Country | US
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Telephone | 515-267-8098
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Fax | 515-224-4493
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Provider Business Mailing Address
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Address Line | 764 KNOLLS CT
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2741
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Country | US
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Telephone | 515-267-8098
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Fax | 515-224-4493
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLARICE L WARREN WEIL
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Credential | PSYD
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Telephone | 515-267-8098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 00749
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License Number State | IA
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