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Individual
KEITH W WEAVER
Active
Individual
KEITH W WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
096467
NY
1041C0700X
Clinical Social Worker
2022013753
MO
1041C0700X
Clinical Social Worker
Primary
323944-3501
UT
1041C0700X
Clinical Social Worker
TH00946205
WV
Other
Enumeration date
02/27/2019
Last updated
12/07/2023
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