Individual
MR. CLINTON PAUL FREDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1501 ARVILLE ST, LAS VEGAS, NV 89102-3838
(702) 259-4646
(702) 259-7791
Mailing address
1501 ARVILLE ST, LAS VEGAS, NV 89102-3838
(702) 259-4646
(702) 259-7791
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2793-C
NV
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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