Individual
STEPHEN PAUL WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4150 ILLINOIS RD, FORT WAYNE, IN 46804-1208
(877) 594-9204
Mailing address
4150 ILLINOIS RD, FORT WAYNE, IN 46804-1208
(877) 594-9204
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3500214A
IN
Other
Enumeration date
06/25/2018
Last updated
03/20/2024
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