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General NPI Number Information
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NPI Number | 1043862881
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Entity Type | Individual
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Provider Name | MADELINE WEYER
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Gender | Female
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 402 E 13TH ST STE 107
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City | JASPER
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State | IN
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Zip | 47546-2438
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Country | US
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Telephone | 317-983-3727
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Fax |
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Provider Business Mailing Address
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Address Line | 3380 S 650W
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City | HUNTINGBURG
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State | IN
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Zip | 47542-9733
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Country | US
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Telephone | 812-309-8683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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