Individual
LINDA R FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC III
Contact information
Practice address
700 WEST AVE S, LA CROSSE, WI 54601-4783
(608) 785-0940
Mailing address
121 S PRAIRIE ST, PRAIRIE DU CHIEN, WI 53821-1418
(608) 326-1770
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39384300
—
WI
Enumeration date
08/10/2005
Last updated
04/10/2014
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