Shane Weideman

NPI #1336697366 in Emmett, Idaho

Provider Information

NPI Number
1336697366
Entity Type
Individual
Name
Shane Weideman
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Mental Health
Enumeration Date
Sep 19, 2016
Last Updated
Sep 19, 2016

Practice Location

Address
2007 E QUAIL RUN RD
City
Emmett
State
Idaho
ZIP Code
83617-5059
Phone
(208) 365-5445

Specialties & Taxonomy Codes

Specialty
Counselor - Mental HealthMental Health

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