Provider Demographics
NPI:1952559049
Name:WEISS, RACHEL (LAC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W CRYSTAL LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-3200
Mailing Address - Country:US
Mailing Address - Phone:856-571-2271
Mailing Address - Fax:
Practice Address - Street 1:504 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:WEST COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08107-1730
Practice Address - Country:US
Practice Address - Phone:609-458-0340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00065700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist