Individual
MELINDA QUINN FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2003 GODWIN AVE, LUMBERTON, NC 28358-3197
(910) 739-8849
(910) 739-8698
Mailing address
2003 GODWIN AVE, LUMBERTON, NC 28358-3197
(910) 739-8849
(910) 739-8698
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4704
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102587
—
NC
Enumeration date
10/02/2006
Last updated
07/09/2007
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