Individual
JACQUELINE WEEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1317 W GRAND AVE, PORT WASHINGTON, WI 53074-2075
(262) 284-5789
(262) 284-5907
Mailing address
1317 W GRAND AVE, PORT WASHINGTON, WI 53074-2075
(262) 284-5789
(262) 284-5907
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7199-123
WI
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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