Individual
MRS. JORDON WEIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E 11TH ST, SPENCER, IA 51301-4436
(712) 262-2922
Mailing address
817 3RD AVE W, SPENCER, IA 51301-3608
(319) 481-1408
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
078869
IA
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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