| NPI | 1053379792 |
|---|---|
| Former Name | KATHLEEN A FREDRICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 147123) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149010724) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2007-07-09 |