Organization
THEODORE J WEBER M DIV PSYD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE WEBER (PSYD)
(478) 475-1299
Entity
Organization
Contact information
Practice address
348 CHELSEA PLACE AVE, ORMOND BEACH, FL 32174-0683
(478) 475-1299
Mailing address
PO BOX 28410, MACON, GA 31221-8410
(478) 475-1299
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY6429
FL
Other
Enumeration date
02/23/2009
Last updated
02/23/2009
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