MEDICARE: ANNE WEESE PSRS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1316132566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE WEESE PSRS

Provider Business Mailing Address
First Line	:	895 WASHINGTON ST SW
Second Line	:
City	:	BLACKSBURG
State	:	VA
Zip	:	24061-1067
Country	:	US
Telephone Number	:	540-231-6557
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 WASHINGTON ST SW
Second Line	:
City	:	BLACKSBURG
State	:	VA
Zip	:	24061-1067
Country	:	US
Telephone Number	:	540-231-6557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	09/29/2014

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