Individual
BARBARA A WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
920 MEDICAL DR, MANILA, AR 72442-8416
(870) 570-0358
Mailing address
PO BOX 717, MANILA, AR 72442-0717
(870) 570-0358
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1313-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W322
BLUECROSS BLIESHIELD
AR
Enumeration date
05/25/2006
Last updated
04/07/2022
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