Individual
MR. DANIEL WILLIAM FREDERICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
418 CENTRE ST UNIT C, BOSTON, MA 02130-5197
(518) 928-5689
Mailing address
418 CENTRE ST UNIT C, BOSTON, MA 02130-5197
(518) 928-5689
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2316
MA
Other
Enumeration date
01/30/2017
Last updated
08/13/2021
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