Individual
BRYCIE WEIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
515 NE GLEN OAK AVE STE 101, PEORIA, IL 61603-3167
(309) 655-7378
Mailing address
113 MIROMAR LN, WASHINGTON, IL 61571-4021
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TC0700X
Clinical Psychologist
071010436
IL
Other
Enumeration date
07/28/2020
Last updated
04/13/2023
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