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1477248664
TIMOTHY FREDRICKSON
MADISON, WI
NPI
1477248664
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WI 11167-125)
Enumeration Date
2023-04-05
Last Update Date
2024-09-10
Business Address
Mr. TIMOTHY FREDRICKSON
660 W WASHINGTON AVE
MADISON, WI 53703-4703
Phone number: 608-444-5106
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Mailing Address
Mr. TIMOTHY FREDRICKSON
PO BOX 294
STOUGHTON, WI 53589-0294
Phone number: 608-444-5106
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