| Doctor Name: | JON WEBER |
| NPI Number: | 1639550775 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MASTER SOCIAL WORK |
| License Number: | |
| Business Practice Address: | 6418 Deans Hill Rd Berrien Center, MI - 491029750 |
| Business Phone Number: | 2698155500 |
| Business Fax Number: | |
| Mailing Address: | 6728 M 140 Hwy, COVERT |
| State: | MI |
| Postal Code: | 490439400 |
| Phone Number: | 2696215527 |
| Fax Number: | |
| NPI Enumeration Date: | 06/15/2015 |
| NPI Last Update Date: | 06/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |