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General NPI Number Information
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NPI Number | 1972040095
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Entity Type | Organization
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Legal Business Name | WEAL INC A PROFESSIONAL PSYCHOLOGICAL CORP
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 65 N MADISON AVE STE 707
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City | PASADENA
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State | CA
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Zip | 91101-2046
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Country | US
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Telephone | 626-817-6665
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Fax |
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Provider Business Mailing Address
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Address Line | 65 N MADISON AVE STE 707
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City | PASADENA
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State | CA
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Zip | 91101-2046
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Country | US
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Telephone | 626-817-6665
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD LABRIE
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Credential | PSY.D.
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Telephone | 626-755-1825
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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 | PSY28600
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License Number State | CA
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