Individual
ANDREA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S, CCC-SLP
Contact information
Practice address
2221 W DETROIT ST, BROKEN ARROW, OK 74012-3628
(918) 615-6492
Mailing address
3108 N ELM PL, BROKEN ARROW, OK 74012-0772
(539) 260-1166
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
26220
CA
235Z00000X
Speech-Language Pathologist
Primary
5842
OK
Other
Enumeration date
07/07/2015
Last updated
08/15/2022
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