Individual
LISA FREDERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5680 POUNCEY TRACT RD, GLEN ALLEN, VA 23059-5314
(804) 364-8080
Mailing address
5680 POUNCEY TRACT RD, GLEN ALLEN, VA 23059-5314
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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