Individual
MS. HOLLY FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3855 GREENSPRING AVE, BALTIMORE, MD 21211-3300
(410) 225-9160
Mailing address
218 N CHARLES ST, APT. #2201, BALTIMORE, MD 21201-4021
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
06881
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AHN811170124
BLUE CROSS BLUE SHIELD
MD
Enumeration date
10/22/2012
Last updated
10/22/2012
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