Individual
ALLYSE WEIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5228 LOVERS LN STE 102, PORTAGE, MI 49002-1521
(734) 649-4284
Mailing address
775 ALFA CT APT 2A, PORTAGE, MI 49002-2982
(734) 649-4294
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
—
MI
Other
Enumeration date
08/30/2021
Last updated
05/01/2025
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