Individual
MRS. KRISTEL JUNE FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
3133 GOOD SHEPHERD WAY, LONGVIEW, TX 75605-7921
(903) 323-6541
(903) 323-6564
Mailing address
3133 GOOD SHEPHERD WAY, LONGVIEW, TX 75605-7921
(903) 323-6541
(903) 323-6564
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT82118
TX
Other
Enumeration date
10/13/2011
Last updated
07/31/2013
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