Provider Demographics
NPI:1508002585
Name:WEAVER, JERI STELSON (MA)
Entity Type:Individual
Prefix:
First Name:JERI
Middle Name:STELSON
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 PENN GRANT RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1826
Mailing Address - Country:US
Mailing Address - Phone:717-917-9999
Mailing Address - Fax:
Practice Address - Street 1:1109 PENN GRANT RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-1826
Practice Address - Country:US
Practice Address - Phone:717-917-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health