| Doctor Name: | JESSICA N WEARY |
| NPI Number: | 1225204134 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | LC11308 |
| Business Practice Address: | 1203 Maine St. Poland, ME - 04274 |
| Business Phone Number: | 2073100026 |
| Business Fax Number: | 2079982232 |
| Mailing Address: | 122 Summit Spring Rd, POLAND |
| State: | ME |
| Postal Code: | 04274 |
| Phone Number: | 2073100026 |
| Fax Number: | 2079982232 |
| NPI Enumeration Date: | 05/01/2008 |
| NPI Last Update Date: | 04/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LC11308 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |