Provider Information for 1336162213
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Ms. CHERRY LOUISE WEAVER
Other Names:Former Name:Ms. CHERRY LOUISE SHAFFER LPCSex: Female
NPI: 1336162213
Last Updated: 2012-01-24
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||
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NPI | 1336162213 | ||||||||||||
Enumeration Date | 2006-07-25 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 7706 WATER FOWL TRL ARLINGTON, TX 76002-4571 United States Phone: 817-247-0880 | Fax:817-626-6400 | ||||||||||||
Primary Practice Address | 111 NW 24TH ST FORT WORTH, TX 76164-8544 United States Phone: 817-626-7640 | Fax:817-626-6400 | ||||||||||||
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