Doctor Name: | MR. MICHAEL LEE WEED |
NPI Number: | 1023251147 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C,S.W, |
License Number: | 36957 |
Business Practice Address: | 1221 Brookfield Ln Mansfield, TX - 760632565 |
Business Phone Number: | 8172390823 |
Business Fax Number: | |
Mailing Address: | 900 N Walnut Creek Dr, Suite 100, P.o. Box 279 MANSFIELD |
State: | TX |
Postal Code: | 760638046 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/20/2009 |
NPI Last Update Date: | 04/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 36957 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |