Individual
ARLENE MAE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD, RN, LMBT
Contact information
Practice address
7210L BROAD RIVER RD, IRMO, SC 29063-7973
(803) 749-1576
(803) 749-1676
Mailing address
7210L BROAD RIVER RD, IRMO, SC 29063-7973
(803) 749-1576
(803) 749-1676
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2260
SC
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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