Individual
TIERRA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
7226 CARDINAL COVE CIR APT 7226, SANFORD, FL 32771-6334
(954) 806-2591
Mailing address
7226 CARDINAL COVE CIR # 7226, SANFORD, FL 32771-6334
(954) 806-2591
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Enumeration date
12/15/2020
Last updated
08/15/2023
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