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Individual

JOHN WEAGLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW,LCADC

Contact information

Practice address
99 BEAUVOIR AVE, SUMMIT, NJ 07901-3533
(973) 971-5595
Mailing address
PO BOX 228, PLUCKEMIN, NJ 07978-0228
(201) 715-8694
(908) 304-0777

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SC00577400
NJ

Other

Enumeration date
02/15/2006
Last updated
07/08/2007
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