Individual
JACLYN A WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2475 UNIVERSITY AVE, SUITE A, GREEN BAY, WI 54302-5099
(920) 469-1201
Mailing address
2475 UNIVERSITY AVE, SUITE A, GREEN BAY, WI 54302-5099
(920) 469-1201
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
946-124
WI
Other
Enumeration date
09/17/2013
Last updated
09/17/2013
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