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Individual
MR. SHANNON PAUL WEISZ
Active
Individual
MR. SHANNON PAUL WEISZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1549
ND
103T00000X
Psychologist
Primary
470
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17326
—
ND
Enumeration date
11/21/2006
Last updated
07/22/2014
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