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Contact Information

JOHN R WEAVER, PSYD
2717 N GRANDVIEW BLVD
#303
WAUKESHA, WI53188
 Phone: 262-544-6486
 Fax: 262-544-6377
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JOHN R WEAVER · (Male)

NPI Number 1376632893
Status Active
Credentials PSYD (Doctor of Psychology)
Entity Individual
Enumeration date 10/12/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 1969057
  • WI Medicaid 39137400
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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