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Individual

SHAWN FREDERICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
424 WASHINGTON ST, SUITE 7, COLUMBUS, IN 47201-6790
(812) 799-1350
Mailing address
424 WASHINGTON ST, SUITE 7, COLUMBUS, IN 47201-6790
(812) 799-1350

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100083280A
IN
Enumeration date
03/08/2010
Last updated
05/02/2013
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