Individual
MARISA FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1133 COLLEGE AVE STE E230, MANHATTAN, KS 66502-2818
(785) 587-1825
Mailing address
1040 SUNSET DR, LAWRENCE, KS 66044-4546
(619) 288-0058
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-56631
KS
Other
Enumeration date
02/08/2019
Last updated
12/01/2023
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