Provider Demographics
NPI:1083836696
Name:WEAKS, KIMBERLY (MS)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:WEAKS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 N FRONT ST
Mailing Address - Street 2:BUILDING 1, SUITE 300
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1086
Mailing Address - Country:US
Mailing Address - Phone:717-635-2574
Mailing Address - Fax:717-635-7167
Practice Address - Street 1:2101 N FRONT ST
Practice Address - Street 2:BUILDING 1, SUITE 300
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1086
Practice Address - Country:US
Practice Address - Phone:717-635-2574
Practice Address - Fax:717-635-7167
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor