Individual
MRS. DEBRA J WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6614 SOUTHERN BLVD, BOARDMAN, OH 44512-3455
(330) 726-8855
(330) 725-6918
Mailing address
6614 SOUTHERN BLVD, BOARDMAN, OH 44512-3455
(330) 726-8855
(330) 725-6918
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP3548
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175078
UNISON
OH
01
—
11738249
CAQH
OH
Enumeration date
07/16/2008
Last updated
07/16/2008
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