Individual
AMANDA LOUISE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2155 STATE ROUTE 22B, MORRISONVILLE, NY 12962-3417
(518) 563-8000
Mailing address
2155 STATE ROUTE 22B, MORRISONVILLE, NY 12962-3417
(518) 563-8000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P126615
NY
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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