Individual
JENNIFER WEICKUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 COLONIAL DR, CLAYTON, NC 27527-8739
(919) 879-8746
(503) 476-2949
Mailing address
204 COLONIAL DR, CLAYTON, NC 27527-8739
(919) 879-8746
(503) 476-2949
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7824
NC
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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