Individual
MRS. FREDERICKA C WILFONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.DIV
Contact information
Practice address
1009 MAITLAND CENTER COMMONS BLVD, SUITE 212, MAITLAND, FL 32751-7270
(800) 840-2528
Mailing address
7729 PINEAPPLE DR, ORLANDO, FL 32835-5311
(321) 276-6692
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMT2141
FL
Other
Enumeration date
06/03/2009
Last updated
10/19/2015
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