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1154140036
BREEANA LEE FREDRICKSEN
STOCKTON, CA
NPI
1154140036
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-10-07
Last Update Date
2024-10-07
Business Address
BREEANA LEE FREDRICKSEN
17986 COPPEROPOLIS RD
STOCKTON, CA 95215-9717
Phone number: 208-993-3469
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Mailing Address
BREEANA LEE FREDRICKSEN
17986 COPPEROPOLIS RD
STOCKTON, CA 95215-9717
Phone number: 208-993-3469
Copy
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