Individual
SHARON W WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 JACKSON ST, ROANOKE RAPIDS, NC 27870
(252) 537-6164
(252) 537-9199
Mailing address
PO BOX 2161, ROANOKE RAPIDS, NC 27870
(252) 537-6164
(252) 537-9199
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1014
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046CA
BLUE CROSS
NC
05
—
89046CA
—
NC
Enumeration date
10/16/2006
Last updated
07/08/2007
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