Provider Demographics
NPI:1548870389
Name:WEAVER, ZABRINA ZENNILE (EDD, LADAC)
Entity type:Individual
Prefix:DR
First Name:ZABRINA
Middle Name:ZENNILE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:EDD, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 W 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-6083
Mailing Address - Country:US
Mailing Address - Phone:870-489-3660
Mailing Address - Fax:
Practice Address - Street 1:407 W 35TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6083
Practice Address - Country:US
Practice Address - Phone:870-489-3660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR399L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty