Doctor Name: | MRS. JESSICA ANN WEYER |
NPI Number: | 1104924018 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW RAPCI LCSW |
License Number: | 12995 |
Business Practice Address: | 3900 W Brown Deer Rd Suite 200 Brown Deer, WI - 53209 |
Business Phone Number: | 4145402170 |
Business Fax Number: | 4145402171 |
Mailing Address: | 3900 W Brown Deer Rd, Suite 200 BROWN DEER |
State: | WI |
Postal Code: | 53209 |
Phone Number: | 4145402170 |
Fax Number: | 4145402171 |
NPI Enumeration Date: | 09/21/2006 |
NPI Last Update Date: | 05/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 12995 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |