Provider Demographics
NPI:1316444631
Name:WEIL, JENNIFER (LIFESTYLE COACH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WEIL
Suffix:
Gender:F
Credentials:LIFESTYLE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4645
Mailing Address - Country:US
Mailing Address - Phone:443-979-0302
Mailing Address - Fax:410-979-0302
Practice Address - Street 1:405 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4645
Practice Address - Country:US
Practice Address - Phone:443-979-0302
Practice Address - Fax:410-979-0302
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator