Individual
JOHN M FREDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9153 W 133RD ST, OVERLAND PARK, KS 66213-4333
(913) 257-5185
Mailing address
9153 W 133RD ST, OVERLAND PARK, KS 66213-4333
(913) 257-5185
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
2020036420
MO
Other
Enumeration date
11/23/2020
Last updated
11/04/2022
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