Mary Jane Fredericks
Behavior Technician in Carlsbad, CA. Individual provider (NPI-1).
NPI number1982308607
StatusActive
Last updated in NPPESMar 28, 2023
Details
- NPI
- 1982308607
- Entity type
- Individual (NPI-1)
- Name
- Mary Jane Fredericks
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 28, 2023
- Certification date
- Mar 28, 2023
- Last updated
- Mar 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
5870 El Camino Real Ste 101Carlsbad, CA 92008-8816
Phone 760-539-5818
Mailing address
5870 El Camino Real Ste 101Carlsbad, CA 92008-8816
Phone 760-539-5818
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