Individual
STACIE LARAE WEIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 OFFICE PARK RD, WEST DES MOINES, IA 50265-2549
(515) 279-2834
(515) 279-4168
Mailing address
1708 2ND AVE SW, ALTOONA, IA 50009-5810
(515) 238-1947
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
05746
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
492664000
—
IA
Enumeration date
10/17/2006
Last updated
03/15/2013
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