Individual
TABATHA L BIRD WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC,MA, MFT
Contact information
Practice address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 397-5211
(503) 397-5373
Mailing address
PO BOX 1234, SAINT HELENS, OR 97051-8234
(503) 397-5211
(503) 397-5373
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2126
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123190
—
OR
Enumeration date
08/01/2007
Last updated
02/25/2008
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