Individual
STEPHANIE WEAVER I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 OLD AIRPORT RD, ST. MICHAEL, AK 99659-0659
(907) 923-2431
Mailing address
P.O. BOX 59027, ST. MICHAEL, AK 99659-0659
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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