Doctor Name: | MS. HOLLY FREDRICKSON |
NPI Number: | 1003169517 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 06881 |
Business Practice Address: | 3855 Greenspring Ave Baltimore, MD - 212113300 |
Business Phone Number: | 4102259160 |
Business Fax Number: | |
Mailing Address: | 218 N Charles St, Apt. #2201 BALTIMORE |
State: | MD |
Postal Code: | 212014021 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/22/2012 |
NPI Last Update Date: | 10/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 06881 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |