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General NPI Number Information
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NPI Number | 1972800928
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Entity Type | Individual
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Provider Name | LYNNE WEIXEL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2011
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 5662 COUNTY ROAD 2330
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City | LENOX
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State | MO
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Zip | 65541-9361
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Country | US
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Telephone | 573-729-4426
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Fax | 573-729-4426
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Provider Business Mailing Address
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Address Line | 5662 COUNTY ROAD 2330
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City | LENOX
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State | MO
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Zip | 65541-9361
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Country | US
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Telephone | 573-729-4426
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Fax | 573-729-4426
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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 | 001352
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2011007901
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License Number State | MO
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