Provider Demographics
NPI:1609245182
Name:WEIBEL, MELISSA IRENE
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:IRENE
Last Name:WEIBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:IRENE
Other - Last Name:MCGIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1213 COURT ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-3803
Mailing Address - Country:US
Mailing Address - Phone:315-507-5800
Mailing Address - Fax:
Practice Address - Street 1:1213 COURT ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-3803
Practice Address - Country:US
Practice Address - Phone:315-507-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program