Individual
DANA MARIE WEIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,L.L.P.,B.C.B.A
Contact information
Practice address
18635 BOWIE ST, SOUTHGATE, MI 48195-2805
(734) 785-7700
Mailing address
18635 BOWIE ST, SOUTHGATE, MI 48195-2805
(734) 785-7705
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
6301009563
MI
103T00000X
Psychologist
Primary
6301009563
MI
Other
Enumeration date
12/22/2009
Last updated
09/02/2022
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