Individual
PATRICIA RENEE FEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
415 N JACKSON ST, AMERICUS, GA 31709-3015
(229) 931-2470
Mailing address
PO BOX 1348, AMERICUS, GA 31709-1348
(229) 931-2470
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC007328
GA
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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