Individual
LAURA SUZANNE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC-I
Contact information
Practice address
110 S 12TH ST, WACO, TX 76701-1810
(254) 752-3451
(254) 756-3133
Mailing address
PO BOX 890, WACO, TX 76703-0890
(254) 752-3451
(254) 756-3133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14728
TX
Other
Enumeration date
08/20/2018
Last updated
04/07/2021
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