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Individual

MRS. DIANE SELLERS WEIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW MSW

Contact information

Practice address
1301 HILL ST, BASTROP, TX 78602-3008
(512) 303-4456
(512) 303-3639
Mailing address
1301 HILL ST, BASTROP, TX 78602-3008
(512) 303-4456
(512) 303-3639

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW 03352
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0065DL
BCBS
05
102931601
TX
Enumeration date
12/27/2006
Last updated
07/13/2010
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