Individual
SAMANTHA RENEE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1524 CREEK KNOLL CT, SOUTH CHESTERFIELD, VA 23834-6820
(804) 874-0227
Mailing address
1524 CREEK KNOLL CT, SOUTH CHESTERFIELD, VA 23834-6820
(804) 874-0227
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-52785
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133002582
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS - BOARD OF MEDICINE
VA
01
—
1-21-52785
BACB
—
Enumeration date
11/29/2017
Last updated
06/18/2025
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