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Individual

MR. WILLIAM MARK FREDERICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
214 KEOWEE TRL, CLEMSON, SC 29631-1448
(864) 367-9023
Mailing address
106 BROOKSTONE WAY, CENTRAL, SC 29630-3604
(864) 367-9023

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4564
SC
106H00000X
Marriage & Family Therapist
MFC 30357
CA

Other

Enumeration date
03/11/2008
Last updated
02/04/2014
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