Provider Demographics
NPI:1295891430
Name:WEILBURG, BARBARA R (RN MS CS)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:R
Last Name:WEILBURG
Suffix:
Gender:F
Credentials:RN MS CS
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:R
Other - Last Name:WEILBURG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN MS CS
Mailing Address - Street 1:177 PARK ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2042
Mailing Address - Country:US
Mailing Address - Phone:617-969-6892
Mailing Address - Fax:617-969-8361
Practice Address - Street 1:177 PARK ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2042
Practice Address - Country:US
Practice Address - Phone:617-969-6892
Practice Address - Fax:617-969-8361
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA138957101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health