Individual
JENNA WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1800 ANADARKO PL, EDMOND, OK 73013-7732
(405) 209-2748
(866) 347-6279
Mailing address
1403 LIMESTONE WAY, ELGIN, OK 73538-1402
(405) 815-7910
(866) 347-6279
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3582
OK
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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