TYESHIA FREDERICKS
Individual Provider (NPI-1)
Active
Behavior Technician
Provider Information
- NPI Number
1023874492- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 11954 S KILDARE AVE APT 1E, ALSIP, IL, 608032325
- Phone
- (773) 960-8783
Specialties & Taxonomies
Behavior Technician
Primary
All Addresses
MAILING
1385 HWY 35 # 284
MIDDLETOWN, NJ, 077482012