Provider Demographics
NPI:1245057934
Name:WEAVER, MARIA (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:HURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 SWEETWATER CT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3029
Mailing Address - Country:US
Mailing Address - Phone:864-263-0015
Mailing Address - Fax:
Practice Address - Street 1:352 PELHAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3111
Practice Address - Country:US
Practice Address - Phone:864-558-0383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XN1300X
SC6704225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation