STACEY LYNN FREDERICKS

OAK LAWN, IL
NPI1023360989
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149.025334)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2012-10-02
Last Update Date2023-02-28
Business Address
STACEY LYNN FREDERICKS
4700 W 95TH ST STE 205
OAK LAWN, IL 60453-2574
Phone number: 708-684-7999
Mailing Address
STACEY LYNN FREDERICKS
4700 W 95TH ST STE 205
OAK LAWN, IL 60453-2574
Phone number: 708-684-7999