Individual
THERESA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 QUAIL LAKE LOOP STE 200, COLORADO SPRINGS, CO 80906-4651
(719) 540-2108
Mailing address
1330 QUAIL LAKE LOOP STE 200, COLORADO SPRINGS, CO 80906-4651
(719) 540-2108
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CO
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/04/2019
Last updated
05/14/2024
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