Provider Demographics
NPI:1427090463
Name:WESTON, MARSHA K (PSYD)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:K
Last Name:WESTON
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 1:431 WARNER ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-1167
Mailing Address - Country:US
Mailing Address - Phone:513-368-4040
Mailing Address - Fax:937-435-9977
Practice Address - Street 1:2717 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:SUITE 218
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-3797
Practice Address - Country:US
Practice Address - Phone:937-435-1847
Practice Address - Fax:937-435-9977
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3963103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical