Provider Demographics
NPI:1811449010
Name:WEIHL, KAYLEE REBECCA-ANN (CDCAP)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:REBECCA-ANN
Last Name:WEIHL
Suffix:
Gender:F
Credentials:CDCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 D COLEGATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750
Mailing Address - Country:US
Mailing Address - Phone:740-376-0930
Mailing Address - Fax:740-376-0933
Practice Address - Street 1:207 D COLEGATE DRIVE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750
Practice Address - Country:US
Practice Address - Phone:740-376-0930
Practice Address - Fax:740-376-0933
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160082101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)