Most Relevant Information
Provider Data
| NPI Number: | 1003425786 |
| Provider Name: | BRYCIE WEIDEN PSY.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | 071010436 |
Most Important Dates
| Enumeration Date: | 07/28/2020 |
| Last Updated: | 04/13/2023 |
Provider Practice Location
515 NE GLEN OAK AVE STE 101
PEORIA
IL
616033167
Practice Location Phone/Fax
| Phone: | 3096557378 |
| Fax: |
Provider Mailing Location
113 MIROMAR LN
WASHINGTON
IL
615714021
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |