Individual
JESSICA WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4505 W DEYOUNG ST STE 203C, MARION, IL 62959-5899
(618) 283-2222
Mailing address
4505 W DEYOUNG ST STE 203C, MARION, IL 62959-5899
(618) 283-2222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/18/2020
Last updated
01/27/2025
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