Provider Demographics
NPI:1053510453
Name:WEIDLER, CHRISTOPHER W (MA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:W
Last Name:WEIDLER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ESSEX ST
Mailing Address - Street 2:BOX 570
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-2325
Mailing Address - Country:US
Mailing Address - Phone:978-473-1676
Mailing Address - Fax:
Practice Address - Street 1:7 RANTOUL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4885
Practice Address - Country:US
Practice Address - Phone:978-927-9410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist