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Individual
EMILY M FREDERICKS
Active
Individual
EMILY M FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301012365
MI
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301012365
MI
Other
Enumeration date
08/21/2006
Last updated
10/19/2020
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