Individual
MIRANDA JO FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW , MSW
Contact information
Practice address
155 PARK DR, SAINT ROBERT, MO 65584-7860
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2023036241
MO
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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