Individual
CAROL WEATHERMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRW
Contact information
Practice address
4000 BIRCH ST, 112, NEWPORT BEACH, CA 92660-2211
(949) 216-3851
(949) 203-0402
Mailing address
4000 BIRCH ST, 112, NEWPORT BEACH, CA 92660-2211
(949) 216-3851
(949) 203-0402
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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