Individual
DR. KENDRA RENEE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
JAMES H. QUILLEN/VAMC, CORNER OF SIDNEY AND LAMONT (JOHNSON CITY), MOUNTAIN HOME, TN 37684
(423) 926-1171
Mailing address
223 MARK DR, GRAY, TN 37615-3856
(423) 926-1171
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
P0000002474
TN
103TC0700X
Clinical Psychologist
P0000002474
TN
Other
Enumeration date
07/10/2006
Last updated
09/11/2025
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