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1255057402
SHASTA WEASE
ELIZABETHTOWN, KY
NPI
1255057402
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2022-10-18
Last Update Date
2022-10-18
Business Address
SHASTA WEASE
907 N MULBERRY ST STE 200
ELIZABETHTOWN, KY 42701-2018
Phone number: 270-982-7372
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Mailing Address
SHASTA WEASE
2810 FRONTIER CT APT 1
RADCLIFF, KY 40160-9075
Phone number: 502-353-8277
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