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General NPI Number Information
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NPI Number | 1639687809
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Entity Type | Organization
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Legal Business Name | JENNIFER WEEKS MS LPC LLC
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 61533 PARRELL RD
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City | BEND
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State | OR
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Zip | 97702-2701
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Country | US
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Telephone | 541-480-9443
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 NE REVERE AVE
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City | BEND
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State | OR
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Zip | 97701-4150
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Country | US
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Telephone | 541-480-9443
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER B WEEKS
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Credential | LPC
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Telephone | 541-480-9443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | C4552
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License Number State | OR
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