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Individual

DELORA MARIE FREDERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3823 AIRPORT BLVD, AUSTIN, TX 78722-1300
(512) 522-2433
Mailing address
8104 NOTTAWAY CV, AUSTIN, TX 78745-7419
(512) 775-3053

Taxonomy

Speciality
Code
Description
License number
State
374J00000X
Doula
Primary

Other

Enumeration date
12/19/2010
Last updated
12/19/2010
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