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General NPI Number Information
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NPI Number | 1659640209
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Entity Type | Organization
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Legal Business Name | DEBORAH L WEIDINGER LMLP, PA
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Dates
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Enumeration Date | 12/27/2011
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 1301 S BROADWAY ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-3119
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Country | US
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Telephone | 913-651-4123
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 S BROADWAY ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-3119
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Country | US
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Telephone | 913-651-4123
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DEBORAH L WEIDINGER
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Credential | LP
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Telephone | 913-651-4123
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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 | 825
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License Number State | KS
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