Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 103TC1900X | Counseling Psychologist |
NPI | 1033732086 |
---|---|
Provider Name | Gabrielle Weierbach |
First Address | Denton, TX 76209-3239 |
Second Address | Addison, TX 75001-3613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2020 |
Last Update Date | 26/05/2020 |