Individual
CANDY LEA WEISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RASI
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RI-W0804131344
CA
171M00000X
Case Manager/Care Coordinator
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Other
Enumeration date
03/24/2009
Last updated
09/13/2012
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