Provider Demographics
NPI:1801275847
Name:WEICKER, MICHELINA EVA (MD, MBA)
Entity type:Individual
Prefix:
First Name:MICHELINA
Middle Name:EVA
Last Name:WEICKER
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4239 PENN AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1373
Mailing Address - Country:US
Mailing Address - Phone:610-670-8800
Mailing Address - Fax:610-670-9800
Practice Address - Street 1:4239 PENN AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1373
Practice Address - Country:US
Practice Address - Phone:610-670-8800
Practice Address - Fax:610-670-9800
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health