Individual
MR. DAVID NICKOLAS WEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
133 E COX ST, FORSYTH, IL 62535
(217) 423-0750
Mailing address
BOX 204, FORSYTH, IL 62535
(217) 423-0750
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0701001960
VA
103T00000X
Psychologist
Primary
—
IL
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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