Individual
CRYSTAL LYNN FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5208 W RENO AVE, OKLAHOMA CITY, OK 73127-6344
(405) 948-4900
(405) 948-4933
Mailing address
4913 W RENO AVE, OKLAHOMA CITY, OK 73127-6339
(405) 948-4900
(405) 948-4933
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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