Provider Demographics
NPI:1164515607
Name:WEYER, SALLY EILEEN (PHD)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:EILEEN
Last Name:WEYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:EILEEN
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:500 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57747-1480
Mailing Address - Country:US
Mailing Address - Phone:605-745-2000
Mailing Address - Fax:
Practice Address - Street 1:500 N 5TH ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:SD
Practice Address - Zip Code:57747-1480
Practice Address - Country:US
Practice Address - Phone:605-745-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD422103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical