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General NPI Number Information
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NPI Number | 1003737214
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Entity Type | Individual
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Provider Name | KYRA MARIE WEAVER M.S. LBS
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Gender | Female
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 930 BOWMAN AVE
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City | WYNNEWOOD
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State | PA
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Zip | 19096-1600
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Country | US
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Telephone | 610-667-3958
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Fax |
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Provider Business Mailing Address
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Address Line | 45 E CITY AVE # 2132
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City | BALA CYNWYD
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State | PA
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Zip | 19004-2421
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Country | US
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Telephone | 609-331-9043
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH008628
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License Number State | PA
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