| Debra A Weaver Phd Llc | |
|
2880 Capital Medical Blvd Suite 2 Tallahassee FL 32308-4671 | |
| (850) 942-5585 | |
| (850) 222-1194 |
| Full Name | Debra A Weaver Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2880 Capital Medical Blvd, Tallahassee, Florida |
| Authorized Official Name and Position | Debra A Weaver (PRESIDENT) |
| Authorized Official Contact | 8509425585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Debra A Weaver Phd Llc 2880 Capital Medical Blvd Suite 2 Tallahassee FL 32308-4671 Ph: (850) 942-5585 | Debra A Weaver Phd Llc 2880 Capital Medical Blvd Suite 2 Tallahassee FL 32308-4671 Ph: (850) 942-5585 |
| NPI Number | 1184913105 |
|---|---|
| Provider Enumeration Date | 03/30/2011 |
| Last Update Date | 03/30/2011 |
| Medicare PECOS PAC ID | 0143404368 |
|---|---|
| Medicare Enrollment ID | O20110413000581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184913105 | NPI | - | NPPES |
| 59382 | Other | FL | BLUE CROSS/BLUE SHIELD OF FLORIDA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY4836 (Florida) | Primary |
| Provider Name | Debra A Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285658047 PECOS PAC ID: 6406030626 Enrollment ID: I20200630001061 |
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