Individual
BRETT WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLADC
Contact information
Practice address
305 FOCH ST, GORDON, NE 69343-1709
(308) 282-1101
(308) 282-1372
Mailing address
305 FOCH ST, GORDON, NE 69343-1709
(308) 282-1101
(308) 282-1372
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P-1423
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470734376-86
—
NE
Enumeration date
08/29/2016
Last updated
08/29/2016
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