Individual
DEBORAH LEE FREDERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1025 N COUNTRY CLUB DR, MESA, AZ 85201-3307
(480) 472-0727
(480) 472-0705
Mailing address
1138 W HEATHERBRAE DR, PHOENIX, AZ 85013-3010
(602) 253-1337
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SPL0992
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
582785
—
AZ
Enumeration date
12/15/2006
Last updated
07/09/2007
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