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Individual
EDWARD EVAN WEIBYE
Active
Individual
EDWARD EVAN WEIBYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305637
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305637
BBHT (BOARD OF BEHAVIORAL HEALTH AND THERAPY
MN
Enumeration date
07/01/2020
Last updated
07/01/2020
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