Individual
MANDA FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 ELLEN DR, BEREA, OH 44017-2810
(440) 655-0520
Mailing address
200 ELLEN DR, BEREA, OH 44017-2810
(440) 655-0520
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
11/15/2024
Last updated
11/15/2024
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