Individual
JEANNINE WESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8293 MIDDLE RUN RD NE, DOVER, OH 44622-7637
(330) 340-9673
Mailing address
8293 MIDDLE RUN RD NE, DOVER, OH 44622-7637
(330) 340-9673
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q017979
—
TN
Enumeration date
02/18/2016
Last updated
11/25/2020
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