| Doctor Name: | MR. GRANT WEAVER |
| NPI Number: | 1356482921 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, CDP, MAC, LMHC |
| License Number: | LH00003794 |
| Business Practice Address: | 178 Francisco Xavier Drive Apartment 9 Cliff Condos & Guest House Agana Heights, GU - 96910 |
| Business Phone Number: | 6714826095 |
| Business Fax Number: | 6713449522 |
| Mailing Address: | Psc 490, Box 9096 FPO |
| State: | AP |
| Postal Code: | 965380490 |
| Phone Number: | 6713449266 |
| Fax Number: | |
| NPI Enumeration Date: | 02/08/2007 |
| NPI Last Update Date: | 04/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH00003794 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |