Provider Demographics
NPI:1740369651
Name:WEYL, CHARLES FREDERICK (MSS, JD, PSYD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FREDERICK
Last Name:WEYL
Suffix:
Gender:M
Credentials:MSS, JD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 IMPERIAL DR
Mailing Address - Street 2:
Mailing Address - City:MOHNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19540-8834
Mailing Address - Country:US
Mailing Address - Phone:610-994-3105
Mailing Address - Fax:610-590-0445
Practice Address - Street 1:731 IMPERIAL DR
Practice Address - Street 2:
Practice Address - City:MOHNTON
Practice Address - State:PA
Practice Address - Zip Code:19540-8834
Practice Address - Country:US
Practice Address - Phone:610-994-3105
Practice Address - Fax:610-590-0445
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007416L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist