Jason Lee Fairweather, LPC, SACIT, CSIT

NPI #1689278590 in Berlin, Wisconsin

Provider Information

NPI Number
1689278590
Entity Type
Individual
Name
Jason Lee Fairweather, LPC, SACIT, CSIT
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Counselor - Professional
Credential
LPC, SACIT, CSIT
Enumeration Date
Nov 23, 2020
Last Updated
Sep 26, 2023

Practice Location

Address
553 BROADWAY
City
Berlin
ZIP Code
54923-1323
Phone
(920) 204-6590

Specialties & Taxonomy Codes

Specialty
Counselor - ProfessionalProfessional

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