Individual
RYAN M FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
515 ENTERPRISE DR 300, LOWELL, AR 72745-8982
(479) 717-7626
(479) 717-7627
Mailing address
515 ENTERPRISE DR 300, LOWELL, AR 72745-8982
(479) 717-7626
(479) 717-7627
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P1509105
AR
Other
Enumeration date
07/31/2007
Last updated
10/01/2015
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