Provider Demographics
NPI:1710176292
Name:WEEKS, CATHERINE JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:JEAN
Last Name:WEEKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 SOUTH WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MOSOCW
Mailing Address - State:ID
Mailing Address - Zip Code:83843
Mailing Address - Country:US
Mailing Address - Phone:208-882-8514
Mailing Address - Fax:208-882-2784
Practice Address - Street 1:818 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-3049
Practice Address - Country:US
Practice Address - Phone:208-882-8514
Practice Address - Fax:208-882-2784
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC 217101YM0800X
IDPSY-202119103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health