| NPI | 1922331883 |
|---|---|
| Former Name | ANGELA M FREDRICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2006010653) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NE 2658) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2024-09-26 |