Individual
ELLEN FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1545 KINGSWAY CT, SUITE 201A, TRENTON, MI 48183-1952
(734) 692-2696
Mailing address
1545 KINGSWAY CT, SUITE 201A, TRENTON, MI 48183-1952
(734) 692-2696
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301002524
MI
Other
Enumeration date
08/31/2006
Last updated
10/30/2007
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