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Individual
MICHAEL ROBERT FREDERIKSEN
Active
Individual
MICHAEL ROBERT FREDERIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
101YA0400X
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
172V00000X
Community Health Worker
10139
CA
Other
Enumeration date
10/18/2019
Last updated
05/20/2024
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