Provider Demographics
NPI:1518644350
Name:WEINZIERL, ALLISON GRACE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:GRACE
Last Name:WEINZIERL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6481 DUNWOODY CIR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2299
Mailing Address - Country:US
Mailing Address - Phone:234-380-7286
Mailing Address - Fax:
Practice Address - Street 1:1490 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3305
Practice Address - Country:US
Practice Address - Phone:513-896-7887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHUU693100OtherLICENSE