Individual
KAYLEE NADINE FREDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
14451 GRAND AVE S, BURNSVILLE, MN 55306
(952) 993-5900
Mailing address
3440 DUPONT AVE S APT 204, MINNEAPOLIS, MN 55408-4069
(920) 257-9647
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10310
MN
Other
Enumeration date
12/17/2019
Last updated
01/06/2020
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