Healthcare Provider Details

I. General information

NPI: 1609136696
Provider Name (Legal Business Name): HEATHER L WEEKLY L.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 05/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 MURDOCK ST
MINGO JUNCTION OH
43938-1062
US

IV. Provider business mailing address

3200 JOHNSON RD
STEUBENVILLE OH
43952-2363
US

V. Phone/Fax

Practice location:
  • Phone: 740-535-1314
  • Fax: 740-535-1290
Mailing address:
  • Phone: 740-264-7751
  • Fax: 740-264-2422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: