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1093961708
TRACEY FREDERIKSEN
PRESCOTT, AZ
NPI
1093961708
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AZ LAC-11878)
Enumeration Date
2008-08-13
Last Update Date
2008-08-13
Business Address
-- TRACEY FREDERIKSEN MC
2228 LAKEWOOD DR
PRESCOTT, AZ 86301-4476
Phone number: 928-583-2580
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Mailing Address
-- TRACEY FREDERIKSEN MC
2228 LAKEWOOD DR
PRESCOTT, AZ 86301-4476
Phone number:
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