Individual
SELENE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
567 N 5TH ST, TERRE HAUTE, IN 47809-1903
(812) 237-3632
Mailing address
1431 6TH AVE, TERRE HAUTE, IN 47807-1211
(937) 417-1944
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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