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Individual

AMY WEISS

Active
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Individual

AMY WEISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1185
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004041000
—
CT
05
—
008003745
—
CT
01
—
008064860
WEISS MEDICAID
CT
Enumeration date
04/19/2016
Last updated
05/13/2016
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