Individual
MRS. SHANNON RACHELLE FREEMAN WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1433 N CYPRESS DR, CARBONDALE, IL 62901-0785
(618) 967-9326
Mailing address
1433 N CYPRESS DR, CARBONDALE, IL 62901-0785
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
11/05/2007
Last updated
11/05/2007
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