| NPI | 1598805814 |
|---|---|
| Former Name | DEMETRA I WEAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 2106) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E4346) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2013-11-06 |