Individual
TRACI FREDERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2150 S COUNTRY CLUB DR STE 34, MESA, AZ 85210-6885
(480) 662-6708
Mailing address
2669 E SHERRI DR, GILBERT, AZ 85296-8636
(602) 573-9274
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-22147
AZ
Other
Enumeration date
06/08/2024
Last updated
06/08/2024
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