Individual
GRACE WEIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5483 FOX CHASE TRL, GALENA, OH 43021-7026
(740) 953-1652
Mailing address
5483 FOX CHASE TRL, GALENA, OH 43021-7026
(740) 953-1652
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
385HR2050X
Respite Care Camp
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
05/04/2024
Last updated
05/04/2024
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