Organization
FREDA WORTHON, M.ED LICENSE PROFESSIONAL COUNSELOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FREDA ANNETTE WORTHON M.ED. (LICENSE PROFESSIONAL COUNSELOR)
(417) 881-1249
Entity
Organization
Contact information
Practice address
5793 S MICHIGAN AVE, SPRINGFIELD, MO 65810-2593
(417) 881-1249
(417) 881-1249
Mailing address
5793 S MICHIGAN AVE, SPRINGFIELD, MO 65810-2593
(417) 881-1249
(417) 881-1249
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
1999136664
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494977416
—
MO
Enumeration date
11/06/2010
Last updated
01/04/2011
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