Organization
DEBRA A WEAVER PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA A WEAVER PHD (PRESIDENT)
(850) 942-5585
Entity
Organization
Contact information
Practice address
2880 CAPITAL MEDICAL BLVD, SUITE 2, TALLAHASSEE, FL 32308-4671
(850) 942-5585
(850) 222-1194
Mailing address
2880 CAPITAL MEDICAL BLVD, SUITE 2, TALLAHASSEE, FL 32308-4671
(850) 942-5585
(850) 222-1194
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4836
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59382
BLUE CROSS/BLUE SHIELD OF FLORIDA
FL
Enumeration date
03/30/2011
Last updated
03/30/2011
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