Provider Demographics
NPI:1508215989
Name:WEAVER, CHRISTIE L (MS/P)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:L
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MS/P
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:OKRAGLESKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40347 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-4840
Mailing Address - Country:US
Mailing Address - Phone:727-330-8932
Mailing Address - Fax:
Practice Address - Street 1:40347 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 103
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-4840
Practice Address - Country:US
Practice Address - Phone:727-330-8932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst