Individual
MRS. LISA ANN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, CCC-SLP
Contact information
Practice address
185 CHARLOIS BLVD, WINSTON SALEM, NC 27103-1521
(336) 725-0222
Mailing address
4204 CLARENDON CREEK CT, WINSTON SALEM, NC 27106-9420
(336) 577-4514
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3019
NC
Other
Enumeration date
02/27/2026
Last updated
02/27/2026
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