Individual
MAI FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2120 W GUADALUPE RD SUITE 7 8 9, MESA, AZ 85202-6457
(602) 230-7373
(480) 629-8577
Mailing address
3101 N CENTRAL AVE STE 550, PHOENIX, AZ 85012-2635
(602) 230-7373
(602) 682-7455
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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