Weaver, Ava N.

Weaver, Ava N. is an individual health care provider with primary practice located at 2323 W Front St , Tyler TX 75702-7704. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Weaver, Ava N. can be contacted via phone (903) 597-1351.

Contact Information

Primary practice address
2323 W Front St Tyler TX 75702-7704
Fax: (903) 535-7386
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 19952 Texas

Profile Details

NPI number 1508917980
LBN Legal business name Weaver, Ava N.
Credentials M.S, NCC,LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 14th, 2007
Last updated Apr 11th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508917980 NPPES
Texas MEDICAID 181244801

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