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Individual
STACY WEAVER
Active
Individual
STACY WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC006231L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019355560003
MA
PA
Enumeration date
04/16/2007
Last updated
06/24/2019
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