Doctor Name: | CHANTEL MARIE WEISENMULLER |
NPI Number: | 1689808883 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 6543 |
Business Practice Address: | 37241 Rocksprings Rd Pomeroy, OH - 457699733 |
Business Phone Number: | 7403504956 |
Business Fax Number: | |
Mailing Address: | 37241 Rocksprings Rd, POMEROY |
State: | OH |
Postal Code: | 457699733 |
Phone Number: | 7403504956 |
Fax Number: | |
NPI Enumeration Date: | 05/04/2009 |
NPI Last Update Date: | 08/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6543 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |