MEDICARE: MS. CHRISTINA ANN-COLBY WEATHERS M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1083917488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA ANN-COLBY WEATHERS M.A.

Provider Business Mailing Address
First Line	:	2200 BERGQUIST DRIVE, SUITE 1
Second Line	:	59 MHS/SGOWV2
City	:	SAN ANTONIO
State	:	TX
Zip	:	78236-9908
Country	:	US
Telephone Number	:	210-292-5972
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 BERGQUIST DRIVE, SUITE 1
Second Line	:	59 MHS/SGOWV2
City	:	SAN ANTONIO
State	:	TX
Zip	:	78236-9908
Country	:	US
Telephone Number	:	210-292-5972
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2010
Last Update Date	:	09/09/2011

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