Individual
DR. KIMBERLY D WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
207 FIRST STREET, JACKSON, MI 49201
(517) 998-4673
Mailing address
207 FIRST STREET, JACKSON, MI 49201
(517) 998-4673
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015342
MI
1041C0700X
Clinical Social Worker
6801082847
MI
Other
Enumeration date
01/09/2013
Last updated
05/06/2013
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