Provider Demographics
NPI:1679866636
Name:WEIG, LEIF (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LEIF
Middle Name:
Last Name:WEIG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 273543
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33427-3543
Mailing Address - Country:US
Mailing Address - Phone:954-614-3414
Mailing Address - Fax:
Practice Address - Street 1:4800 LINTON BLVD STE E314
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6500
Practice Address - Country:US
Practice Address - Phone:954-614-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9087103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical