Healthcare Provider Details

I. General information

NPI: 1295653905
Provider Name (Legal Business Name): DANIELLE R WEAVER PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE R WILSON

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 JAMISON ST
KIRKSVILLE MO
63501-3943
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 660-665-1962
  • Fax: 660-627-0642
Mailing address:
  • Phone: 417-761-5214
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026034179
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: