Individual
JESSICA JUEL WEIDERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC, LADC
Contact information
Practice address
220 RAILROAD ST SE, PINE CITY, MN 55063-1540
(320) 629-7600
(651) 925-0071
Mailing address
220 RAILROAD ST SE, PINE CITY, MN 55063-1540
(320) 629-7600
(651) 925-0071
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303647
MN
101YM0800X
Mental Health Counselor
Primary
CC01059
MN
Other
Enumeration date
11/25/2015
Last updated
11/25/2015
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