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1558561381
STACEY WEAVER
CERES, CA
NPI
1558561381
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-07-19
Last Update Date
2012-11-07
Business Address
-- STACEY WEAVER
1904 RICHLAND AVE
CERES, CA 95307-4562
Phone number: 209-541-2125
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Mailing Address
-- STACEY WEAVER
2324 BUDD ST
MODESTO, CA 95350-2505
Phone number: 209-527-3270
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