Individual
MR. KENNETH L. FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1925 S PERIMETER RD, SUITE 120, FT LAUDERDALE, FL 33309-7122
(954) 958-0988
(954) 958-3527
Mailing address
3868 NE 169TH ST APT 303, NORTH MIAMI BEACH, FL 33160-3210
(954) 958-0988
(954) 958-3527
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT1560
FL
Other
Enumeration date
05/15/2007
Last updated
07/09/2007
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