Individual
MS. FREDERICKA L DEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASE MANAGER
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
Mailing address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 603-8612
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.195278
OH
171M00000X
Case Manager/Care Coordinator
1376187419
OH
175T00000X
Peer Specialist
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0379221
—
OH
Enumeration date
11/01/2019
Last updated
03/23/2026
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