Individual
DR. SUSAN FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
232 RUSTLING WILLOW ST., UTE MOUNTAIN UTE HEALTH CENTER, TOWAOC, CO 81334-0049
(970) 565-4441
(970) 564-4784
Mailing address
PO BOX 49, UTE MOUNTAIN UTE HEALTH CENTER, TOWAOC, CO 81334-0049
(970) 565-4441
(970) 564-4784
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
629
NM
Other
Enumeration date
10/28/2013
Last updated
10/28/2013
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