Provider Demographics
NPI:1528361946
Name:WESTON, LOREN LEE (BA)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:LEE
Last Name:WESTON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 WATERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-1427
Mailing Address - Country:US
Mailing Address - Phone:781-710-2647
Mailing Address - Fax:
Practice Address - Street 1:52 WATERSIDE RD
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-1427
Practice Address - Country:US
Practice Address - Phone:781-710-2647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health