Individual
HEIDI R FREDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP-CF
Contact information
Practice address
707 S UNIVERSITY AVE, BEAVER DAM, WI 53916-3027
(920) 887-7181
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6614
WI
Other
Enumeration date
06/16/2023
Last updated
10/07/2024
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