Doctor Name: | TRACY J WEILAND |
NPI Number: | 1003070376 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PLMHP |
License Number: | 8598 |
Business Practice Address: | 124 S 24th St Ste 230 Omaha, NE - 681021226 |
Business Phone Number: | 4029785656 |
Business Fax Number: | 4025915075 |
Mailing Address: | 200 W 7th St, Box 3 LEXINGTON |
State: | NE |
Postal Code: | 688501890 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/15/2008 |
NPI Last Update Date: | 07/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 8598 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |