Individual
AUDREY E WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2410 GRAPE RD STE 6, MISHAWAKA, IN 46545-3015
(574) 217-0128
(574) 288-3447
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9056
(419) 695-8010
(419) 695-0004
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/30/2020
Last updated
09/28/2020
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