Provider Demographics
NPI:1558858134
Name:MERRIWEATHER, FAITH NICHOLE
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:NICHOLE
Last Name:MERRIWEATHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 WINDING TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:GRANITEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29829-6036
Mailing Address - Country:US
Mailing Address - Phone:803-215-4412
Mailing Address - Fax:
Practice Address - Street 1:2112 WINDING TRAIL RD
Practice Address - Street 2:
Practice Address - City:GRANITEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29829-6036
Practice Address - Country:US
Practice Address - Phone:803-215-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker