Individual
JODY LYNN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 S LINCOLN AVE, LEBANON, PA 17042-7529
(717) 272-6621
Mailing address
124 CASSADEE CT, LEBANON, PA 17042-9578
(717) 679-6087
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL007921
PA
Other
Enumeration date
10/28/2006
Last updated
07/08/2007
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