Individual
MARGUERITE NONNIE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
208 CHURCH ST, KELSO, WA 98626-3409
(360) 425-1322
Mailing address
208 CHURCH ST, KELSO, WA 98626-3409
(360) 425-1322
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00005696
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WE3213
REGENCE BLUE SHIELD OF WA
WA
Enumeration date
05/18/2006
Last updated
07/09/2007
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