Provider Demographics
NPI:1437563608
Name:WEISS, RACHEL BENDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:BENDER
Last Name:WEISS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ELIZA
Other - Last Name:BENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 MILL ST
Mailing Address - Street 2:MAIL STOP 113
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1064
Mailing Address - Country:US
Mailing Address - Phone:617-448-5078
Mailing Address - Fax:617-855-3776
Practice Address - Street 1:115 MILL ST
Practice Address - Street 2:MAIL STOP 113
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1064
Practice Address - Country:US
Practice Address - Phone:617-448-5078
Practice Address - Fax:617-855-3776
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9826103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical