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1255934485
TASHA JANE FREDERICK
PORTAGE, MI
NPI
1255934485
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-11-19
Last Update Date
2020-11-19
Business Address
TASHA JANE FREDERICK
526 W CENTRE AVE
PORTAGE, MI 49024-5306
Phone number: 269-321-9556
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Mailing Address
TASHA JANE FREDERICK
526 W CENTRE AVE
PORTAGE, MI 49024-5306
Phone number:
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