Individual
MS. AVA N. WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S, NCC,LPC
Contact information
Practice address
2323 W FRONT ST, TYLER, TX 75702-7704
(903) 597-1351
(903) 535-7386
Mailing address
PO BOX 4730, TYLER, TX 75712-4730
(903) 597-1351
(903) 535-7386
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
19952
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181244801
—
TX
Enumeration date
01/14/2007
Last updated
04/11/2012
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