Individual
MRS. LATISHA S. FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
590 MARSHALL ST, PHILLIPSBURG, NJ 08865-2629
(908) 387-0003
(908) 387-0005
Mailing address
1037 W TILGHMAN ST, ALLENTOWN, PA 18102-2226
(929) 225-9488
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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