Individual
PATRICIA GILLETTE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3802 CLEMMONS RD # H, CLEMMONS, NC 27012-8478
(336) 462-0369
Mailing address
3802 CLEMMONS RD # H, CLEMMONS, NC 27012-8478
(336) 462-0369
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
761
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86161
NCBCBS PROVIDER #
NC
Enumeration date
11/08/2006
Last updated
07/08/2007
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