Individual
SUSAN M FREDRICKSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
655 W HWY 50, SUITE 104, CLERMONT, FL 34711-2913
(352) 394-5922
(352) 360-6582
Mailing address
2950 PLAZA TERRACE DR, ORLANDO, FL 32803-2825
(352) 394-5922
(352) 360-6582
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
MH 4648
FL
Other
Enumeration date
04/14/2006
Last updated
07/09/2007
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