Individual
KATELYNN FREDERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
902 GRINDE DR, FOUNTAIN, CO 80817-1752
(718) 702-9019
Mailing address
902 GRINDE DR, FOUNTAIN, CO 80817-1752
(718) 702-9019
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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