Individual
REBECCA WEIDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCMHC
Contact information
Practice address
113 HERBERT ST, PORT ORANGE, FL 32129-3517
(484) 876-1545
Mailing address
113 HERBERT ST, PORT ORANGE, FL 32129-3517
(484) 876-1545
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/13/2016
Last updated
06/14/2024
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