Individual
DR. MARIANNE A. WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
410 S 20TH ST, LA GRANDE, OR 97850-3538
(541) 663-9350
Mailing address
410 S 20TH ST, LA GRANDE, OR 97850-3538
(541) 663-9350
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1524
OR
Other
Enumeration date
02/26/2010
Last updated
02/26/2010
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