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Individual

RONDA JANETTE WEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.C.

Contact information

Practice address
901 S BROADWAY, HOBART, OK 73651-1834
(580) 726-3383
(580) 726-3384
Mailing address
RR 2 BOX 248, FORT COBB, OK 73038-9314
(405) 668-0147

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4194
OK
101YP2500X
Professional Counselor
Primary
4194
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093897415
OK
Enumeration date
01/04/2012
Last updated
01/04/2012
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