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General NPI Number Information
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NPI Number | 1174585988
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Entity Type | Individual
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Provider Name | WENDY FREDERICKSON TRUDEAU LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 4045 LANGSTON PL APT L
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City | SYLVANIA
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State | OH
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Zip | 43560-9366
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Country | US
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Telephone | 843-214-8054
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Fax | 843-954-0114
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Provider Business Mailing Address
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Address Line | 4045 LANGSTON PL APT L
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City | SYLVANIA
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State | OH
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Zip | 43560-9366
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Country | US
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Telephone | 843-214-8054
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Fax | 843-954-0114
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2405660
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 4701
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7629-123
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License Number State | WI
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