Individual
CARMEN SHAFE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
1318 W 6TH ST, KEWANEE, IL 61443-1261
(309) 852-5696
Mailing address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(815) 489-4470
(815) 490-5858
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007060
IL
Other
Enumeration date
04/04/2007
Last updated
08/23/2024
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