Thea Renee Fredericksen, M.A., OTR/L

NPI #1598178204 in San Clemente, California

Provider Information

NPI Number: 1598178204
Entity Type: Individual
Name: Thea Renee Fredericksen, M.A., OTR/L
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: M.A., OTR/L
Enumeration Date: Jun 10, 2014
Last Updated: Nov 30, 2016

Practice Location

Address: 970 CALLE AMANECER
Address 2: STE A
City: San Clemente
State: California
ZIP Code: 92673-6250
Phone: (949) 498-5100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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