Individual
DOUG WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1140 36TH ST STE 270, OGDEN, UT 84403-2064
(801) 389-6696
Mailing address
1140 36TH ST STE 270, OGDEN, UT 84403-2064
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
342872-6006
UT
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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