Individual
MS. ELLEN VICKY WEISBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
325 S 20TH ST, PHILADELPHIA, PA 19103-6533
(215) 985-1947
(215) 985-3633
Mailing address
325 S 20TH ST, PHILADELPHIA, PA 19103-6533
(215) 985-1947
(215) 985-3633
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS-006488-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50001372
CAPITAL BLUE CROSS
PA
01
—
731333
BLUE SHIELD
PA
Enumeration date
06/29/2006
Last updated
07/08/2007
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