Individual
MRS. CHELSEA VICTORIA FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 569-4300
Mailing address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 569-4300
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111258
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
361337401
—
TX
Enumeration date
09/01/2016
Last updated
06/19/2019
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