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General NPI Number Information
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NPI Number | 1851447916
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Entity Type | Individual
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Provider Name | KYLE N. WEIR PH.D., LMFT
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CSU FRESNO DEPT OF CSER 5005 N. MAPLE AVE. MS ED 3
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City | FRESNO
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State | CA
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Zip | 93740-0001
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Country | US
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Telephone | 559-278-0169
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Fax | 559-278-0045
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Provider Business Mailing Address
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Address Line | 29795 KINGS CANYON CT S
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City | COARSEGOLD
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State | CA
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Zip | 93614-9580
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Country | US
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Telephone | 559-658-8842
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 44063
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | IL
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