Individual
DR. RICHARD IVAN FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1244 E WALNUT ST, SPRINGFIELD, MO 65802-3423
(417) 766-4373
(417) 874-1633
Mailing address
1244 E WALNUT ST, SPRINGFIELD, MO 65802-3423
(417) 766-4373
(417) 874-1633
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
R0334
MO
Other
Enumeration date
01/26/2006
Last updated
07/29/2009
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