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General NPI Number Information
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NPI Number | 1689855199
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Entity Type | Individual
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Provider Name | STEVEN L WEISS PHD
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Gender | Male
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 7655 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-7904
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Country | US
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Telephone | 352-563-0333
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Fax | 352-564-1844
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Provider Business Mailing Address
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Address Line | PO BOX 1599
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City | CRYSTAL RIVER
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State | FL
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Zip | 34423-1599
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Country | US
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Telephone | 352-563-0333
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Fax | 352-564-1844
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY4104
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License Number State | FL
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