Provider Demographics
NPI:1093851404
Name:WELLER, TRUDY ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:TRUDY
Middle Name:ANN
Last Name:WELLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:TRUDY
Other - Middle Name:ANN
Other - Last Name:KLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:212 HIGH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464
Mailing Address - Country:US
Mailing Address - Phone:484-941-0500
Mailing Address - Fax:484-941-0515
Practice Address - Street 1:361 HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464
Practice Address - Country:US
Practice Address - Phone:610-326-9250
Practice Address - Fax:610-327-8726
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional