MEDICARE: BARBARA R. WEILBURG RN MS CS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	138957	MA

General Provider Information

NPI Number	:	1295891430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA R. WEILBURG RN MS CS

Provider Business Mailing Address
First Line	:	177 PARK ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02458-2042
Country	:	US
Telephone Number	:	617-969-6892
Fax Number	:	617-969-8361

Provider Business Practice Location Address
First Line	:	177 PARK ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02458-2042
Country	:	US
Telephone Number	:	617-969-6892
Fax Number	:	617-969-8361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	07/08/2007

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