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Individual
MRS. THERESA M. WEAVER
Active
Individual
MRS. THERESA M. WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.C.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401004225
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12443729
CAQH
MI
Enumeration date
04/04/2006
Last updated
02/23/2015
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