Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 20126 | TX |
Y | 101YP2500X | Professional Counselor | 20126 | TX |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1154591584 |
---|---|
Provider Name | Mrs. Jeanette Ann Weems |
First Address | Fort Worth, TX 76244-9105 |
Second Address | Fort Worth, TX 76244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2008 |
Last Update Date | 03/09/2018 |