| Doctor Name: | MS. JANE HENNINGER WEILAND |
| NPI Number: | 1215068010 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CACII |
| License Number: | 6364 |
| Business Practice Address: | 35 N Ash St Cortez, CO - 813213201 |
| Business Phone Number: | 9705654109 |
| Business Fax Number: | 9705658804 |
| Mailing Address: | 35 N Ash St, CORTEZ |
| State: | CO |
| Postal Code: | 813213201 |
| Phone Number: | 9705654109 |
| Fax Number: | 9705658804 |
| NPI Enumeration Date: | 03/07/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 6364 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |