| NPI | 1487085544 |
|---|---|
| Former Name | MELINDA LAUREL FREDERICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW018216) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW129440) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2018-10-24 |