Basic Information
| Provider Information | |||||||||
| NPI: | 1790924124 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBER | ||||||||
| FirstName: | CASSANDRA | ||||||||
| MiddleName: | SUE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PC/TEMPORARY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 551 CINCINNATI-BATAVIA PIKE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452441518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137521555 | ||||||||
| FaxNumber: | 5137532144 | ||||||||
| Practice Location | |||||||||
| Address1: | 551 CINCINNATI-BATAVIA PIKE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452441518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137521555 | ||||||||
| FaxNumber: | 5137532144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2009 | ||||||||
| LastUpdateDate: | 02/09/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C.0700083-TEMP | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.