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1376073189
KEVIN WEAVER
RUSTON, LA
NPI
1376073189
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-06-14
Last Update Date
2022-07-21
Business Address
KEVIN WEAVER
775 SOUTH BONNER STREET
RUSTON, LA 71270
Phone number: 318-254-7050
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Mailing Address
KEVIN WEAVER
775 S BONNER ST
RUSTON, LA 71270-5801
Phone number: 318-254-7050
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