Individual
FREDERICK WEATHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
2512 N VELASCO ST STE 300, ANGLETON, TX 77515-3180
(832) 457-3540
Mailing address
2527 S 11TH ST, NILES, MI 49120-4747
(269) 262-1815
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
33708
TX
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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