Individual
MATTHEW RICHARD FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2001 CLUB MANOR DR STE J, MAUMELLE, AR 72113-7417
(501) 687-0488
(501) 687-0489
Mailing address
2001 CLUB MANOR DR STE J, MAUMELLE, AR 72113-7417
(501) 687-0488
(501) 687-0489
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1475-C
AR
Other
Enumeration date
07/24/2006
Last updated
03/23/2016
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