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Individual

REBECCA SKYLAR FREDRICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L

Contact information

Practice address
5699 W 20TH ST, GREELEY, CO 80634-3165
(970) 451-1234
Mailing address
4248 DIXON ST, TIMNATH, CO 80525-9010

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0008497
CO
225XP0200X
Pediatric Occupational Therapist
OT.0008497
CO

Other

Enumeration date
07/08/2024
Last updated
07/08/2024
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