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1922073642
TIMOTHY FREDRICKSON
ROCKFORD, IL
NPI
1922073642
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 180-001837)
Enumeration Date
2006-02-17
Last Update Date
2023-11-06
Business Address
Mr. TIMOTHY FREDRICKSON LCPC
1639 N ALPINE RD STE 403
ROCKFORD, IL 61107-1440
Phone number: 815-229-7102
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Mailing Address
Mr. TIMOTHY FREDRICKSON LCPC
1639 N ALPINE RD STE 403
ROCKFORD, IL 61107-1440
Phone number: 815-229-7102
Copy
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