Doctor Name: | DR. FREDERICK JACOB REDEKOP |
NPI Number: | 1740329838 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D., LPC |
License Number: | PC004968 |
Business Practice Address: | 201 N 4th Ave Royersford, PA - 194681952 |
Business Phone Number: | 6109480393 |
Business Fax Number: | |
Mailing Address: | 2311 Diamond Pl, ROYERSFORD |
State: | PA |
Postal Code: | 194682279 |
Phone Number: | 6103016454 |
Fax Number: | |
NPI Enumeration Date: | 02/05/2007 |
NPI Last Update Date: | 04/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | PC004968 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |