Individual
MRS. JESSICA RAE WEITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
375 APPLE TREE DR, IONIA, MI 48846-7506
(616) 527-1790
Mailing address
1119 ATLANTIC ST NW, GRAND RAPIDS, MI 49504-4032
(616) 776-2556
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801085728
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801085728
MASTER'S SOCIAL WORKER LIMITED LICENSE
MI
Enumeration date
05/07/2009
Last updated
05/07/2009
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