Joshua Lee Fredrickson, LADC, CBIS

NPI #1871047589 in Crystal, Minnesota

Provider Information

NPI Number: 1871047589
Entity Type: Individual
Name: Joshua Lee Fredrickson, LADC, CBIS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: LADC, CBIS
Enumeration Date: Aug 10, 2016
Last Updated: Aug 10, 2016

Practice Location

Address: 6724 43RD AVE N
City: Crystal
State: Minnesota
ZIP Code: 55428-5239
Phone: (612) 309-8183

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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