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1386698785
TIMOTHY M WEAVER
TAOS, NM
NPI
1386698785
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NM 0088771)
Enumeration Date
2006-05-20
Last Update Date
2007-07-08
Business Address
Mr. TIMOTHY M WEAVER
413 SIPAPU ROAD BOX 6952
TAOS, NM 87571
Phone number: 505-758-5857
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Mailing Address
Mr. TIMOTHY M WEAVER
HC 81 BOX 13
QUESTA, NM 87556
Phone number: 505-770-6737
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