Provider Demographics
NPI:1033495239
Name:WEAVER, LAUREL N (MSW , LISW-S)
Entity Type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:N
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MSW , LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 N. SPRING STREET
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817
Mailing Address - Country:US
Mailing Address - Phone:419-296-8591
Mailing Address - Fax:419-932-6740
Practice Address - Street 1:105 VINE ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:OH
Practice Address - Zip Code:45817-1251
Practice Address - Country:US
Practice Address - Phone:419-296-8591
Practice Address - Fax:419-932-6740
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical