Provider Demographics
NPI:1093797896
Name:WEATHERS, JANET S (JANET WEATHERS PSYD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:S
Last Name:WEATHERS
Suffix:
Gender:F
Credentials:JANET WEATHERS PSYD
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:WEATHERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JANET WEATHERS PSYD
Mailing Address - Street 1:99 E CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3647
Mailing Address - Country:US
Mailing Address - Phone:508-650-3800
Mailing Address - Fax:508-650-3818
Practice Address - Street 1:99 E CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3647
Practice Address - Country:US
Practice Address - Phone:508-650-3800
Practice Address - Fax:508-650-3818
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7940103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06128OtherBLUE CROSS/BLUE SHIELD
MAW51028Medicare ID - Type UnspecifiedPSYCHOLOGIST