Individual
BROOKE A FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
503 HICKORY LN # A, MONTICELLO, IN 47960-2322
(812) 202-6840
Mailing address
503 HICKORY LN # A, MONTICELLO, IN 47960-2322
(812) 202-6840
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
29001959A
IN
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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