Individual
MAI FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
8041
AZ
363A00000X
Physician Assistant
Primary
PA-8041
AZ
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
8041
AZ
Other
Enumeration date
05/08/2019
Last updated
04/07/2025
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