Individual
GINA WEIDOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1169 WYOMING AVE, FORTY FORT, PA 18704-4003
(570) 904-7363
(570) 227-1591
Mailing address
228 S MAIN AVE, SCRANTON, PA 18504-2545
(570) 904-7363
(570) 348-4079
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW026013
PA
Other
Enumeration date
08/20/2020
Last updated
06/18/2025
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