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NPI Code Detail

MEDICARE: MRS. CHERIE DAWN FREDERICKS OTR/L

MEDICARE:  MRS. CHERIE DAWN FREDERICKS  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist4092NC

General Provider Information

NPI Number : 1326474339
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERIE DAWN FREDERICKS OTR/L
Provider Business Mailing Address
First Line : 8205 CROWS NEST LN
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-9294
Country : US
Telephone Number : 336-298-4416
Fax Number :
Provider Business Practice Location Address
First Line : 8205 CROWS NEST LN
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-9294
Country : US
Telephone Number : 336-298-4416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2013
Last Update Date : 09/23/2013

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Directions to “ MRS. CHERIE DAWN FREDERICKS OTR/L” Practice Location

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