Individual
MR. FREDRICK CARL WIDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC II, CADC II, CDP
Contact information
Practice address
11160 HURON ST STE 32, NORTHGLENN, CO 80234-3335
(720) 510-9115
(720) 510-9103
Mailing address
11160 HURON ST STE 32, NORTHGLENN, CO 80234-3335
(720) 510-9115
(720) 510-9103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13-R-26
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB.0008070
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP 60144815
WA
Other
Enumeration date
01/16/2015
Last updated
06/05/2019
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