Provider Demographics
NPI:1013060557
Name:MEYROWITZ-WEISS, DEBORAH ILA (MED, LMFT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ILA
Last Name:MEYROWITZ-WEISS
Suffix:
Gender:F
Credentials:MED, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 JAYMOR RD
Mailing Address - Street 2:SUITE A120
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3826
Mailing Address - Country:US
Mailing Address - Phone:215-355-8812
Mailing Address - Fax:215-355-9026
Practice Address - Street 1:688 KNOWLES AVE
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4102
Practice Address - Country:US
Practice Address - Phone:215-364-3722
Practice Address - Fax:215-968-9034
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000480106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist