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Individual

MRS. PAMELA ANNETTE WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., LPC

Contact information

Practice address
12747 OLIVE BLVD, SAINT LOUIS, MO 63141-6290
(636) 579-8816
Mailing address
PO BOX 2490, HILLSBORO, MO 63050-8490
(636) 579-8816

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
2018024701
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
2018024701
MO
101YM0800X
Mental Health Counselor
2018024701
MO
101YP2500X
Professional Counselor
Primary
2018024701
MO

Other

Enumeration date
07/02/2018
Last updated
04/09/2021
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