Doctor Name: | MS. DEANNE (DEE) K WEAVER |
NPI Number: | 1245494582 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHP |
License Number: | 4261 |
Business Practice Address: | 1303 Lake Ave Gothenburg, NE - 691381744 |
Business Phone Number: | 3085291040 |
Business Fax Number: | |
Mailing Address: | 1303 Lake Ave, GOTHENBURG |
State: | NE |
Postal Code: | 691381744 |
Phone Number: | 3085291040 |
Fax Number: | |
NPI Enumeration Date: | 07/16/2008 |
NPI Last Update Date: | 01/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 4261 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |