Heather Leigh Frederick, MA

NPI #1881175578 in Lake Park, Georgia

Provider Information

NPI Number: 1881175578
Entity Type: Individual
Name: Heather Leigh Frederick, MA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Credential: MA
Enumeration Date: Aug 22, 2018
Last Updated: Aug 22, 2018

Practice Location

Address: 5310 MOSS OAK TRL
City: Lake Park
State: Georgia
ZIP Code: 31636-3300
Phone: (217) 299-1074

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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