Provider Demographics
NPI:1508157488
Name:WEBER, MARIA MARCELLA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MARCELLA
Last Name:WEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 RENAISSANCE POINTE
Mailing Address - Street 2:#204
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3547
Mailing Address - Country:US
Mailing Address - Phone:407-637-9475
Mailing Address - Fax:
Practice Address - Street 1:814 RENAISSANCE POINTE
Practice Address - Street 2:#204
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3547
Practice Address - Country:US
Practice Address - Phone:407-637-9475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor