Provider Demographics
NPI:1417145905
Name:PROCTOR-WEBER, ZOE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:ZOE
Middle Name:E
Last Name:PROCTOR-WEBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13523 CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3105
Mailing Address - Country:US
Mailing Address - Phone:239-269-7861
Mailing Address - Fax:
Practice Address - Street 1:13523 CAPITOL DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3105
Practice Address - Country:US
Practice Address - Phone:239-269-7861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY-7554103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist