Individual
SAUNDRA L FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6202 CONSTITUTION DR, SUITE D, FORT WAYNE, IN 46804-1583
(260) 432-0066
(260) 432-8503
Mailing address
6202 CONSTITUTION DR, SUITE D, FORT WAYNE, IN 46804-1583
(260) 432-0066
(260) 432-8503
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002773A
IN
Other
Enumeration date
09/14/2012
Last updated
11/23/2015
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