Provider Demographics
NPI:1578785358
Name:INGERSOLL, WEBER PAHLA (PHD)
Entity Type:Individual
Prefix:DR
First Name:WEBER
Middle Name:PAHLA
Last Name:INGERSOLL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 TROOST AVE
Mailing Address - Street 2:RM. 206
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-2030
Mailing Address - Country:US
Mailing Address - Phone:816-235-5185
Mailing Address - Fax:
Practice Address - Street 1:4825 TROOST AVE
Practice Address - Street 2:RM. 206
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-2030
Practice Address - Country:US
Practice Address - Phone:816-235-5185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY 01477103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling