Individual
SAMUEL FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
579 DONOFRIO DR STE 206, MADISON, WI 53719-2839
(608) 424-9100
Mailing address
563 STONEWOOD CT, EVANSVILLE, WI 53536-9001
(920) 960-0548
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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