Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6362009207 | MI |
NPI | 1023616166 |
---|---|
Provider Name | Julianna Weir |
First Address | Imlay City, MI 48444-8837 |
Second Address | Marquette, MI 49855-4350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2020 |
Last Update Date | 12/10/2020 |