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1104180520
MICK FREDRICKSON
ALBANY, OR
NPI
1104180520
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L6743)
Enumeration Date
2012-06-29
Last Update Date
2021-04-14
Business Address
MICK FREDRICKSON LCSW
425 2ND AVE SW STE 102
ALBANY, OR 97321-2483
Phone number: 541-286-3209
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Mailing Address
MICK FREDRICKSON LCSW
425 2ND AVE SW STE 102
ALBANY, OR 97321-2483
Phone number: 541-286-3209
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