Individual
JIMMIE DWAYNE FEDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1901 VETERANS MEMORIAL DR, BUILDING #215; ROOM 121, TEMPLE, TX 76504-7451
(254) 743-1647
Mailing address
1901 VETERANS MEMORIAL DR, BUILDING #215; ROOM 121, TEMPLE, TX 76504-7451
(254) 743-1647
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
60729
TX
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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