Individual
DR. ADDIE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4328 PAGE AVE, MICHIGAN CENTER, MI 49254-1077
(517) 764-3609
Mailing address
8540 OAK RIDGE TRL, DEXTER, MI 48130-8620
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801102200
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801102200
MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
07/02/2018
Last updated
07/02/2018
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