Individual
LYDIA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
4000 W MICHIGAN AVE, LANSING, MI 48917
(517) 624-2395
(517) 668-6772
Mailing address
4000 W MICHIGAN AVE, LANSING, MI 48917-2856
(517) 624-2395
(517) 668-6772
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
MI
Other
Enumeration date
02/21/2017
Last updated
10/15/2018
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