Provider Demographics
NPI:1740535723
Name:WEBBER, DANA KRISTEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:KRISTEN
Last Name:WEBBER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 CROASDAILE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6806
Mailing Address - Country:US
Mailing Address - Phone:919-384-9682
Mailing Address - Fax:
Practice Address - Street 1:3310 CROASDAILE DR
Practice Address - Street 2:SUITE 400
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6806
Practice Address - Country:US
Practice Address - Phone:919-384-9682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4309103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist