Provider Demographics
NPI:1336350487
Name:WEBER, SHELLEY MARGED (PHD, FPPR)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:MARGED
Last Name:WEBER
Suffix:
Gender:F
Credentials:PHD, FPPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PRINCETON CT
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2119
Mailing Address - Country:US
Mailing Address - Phone:610-525-2022
Mailing Address - Fax:610-964-8887
Practice Address - Street 1:987 OLD EAGLE SCHOOL RD
Practice Address - Street 2:SUITE 712
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1708
Practice Address - Country:US
Practice Address - Phone:610-687-6008
Practice Address - Fax:610-964-8887
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-002925L103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA182983Medicare ID - Type Unspecified