Provider Demographics
NPI:1891959250
Name:WEBER, KURT ANDREW (PHD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:ANDREW
Last Name:WEBER
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 1:100 GRANT ST
Mailing Address - Street 2:ST. NORBERT COLLEGE
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-2002
Mailing Address - Country:US
Mailing Address - Phone:920-403-3266
Mailing Address - Fax:920-403-3099
Practice Address - Street 1:100 GRANT ST
Practice Address - Street 2:ST. NORBERT COLLEGE
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-2002
Practice Address - Country:US
Practice Address - Phone:920-403-3266
Practice Address - Fax:920-403-3099
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2630-057103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling