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General NPI Number Information
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NPI Number | 1356093959
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Entity Type | Individual
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Provider Name | ALEAHA DEANN FREDERICK
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Gender | Female
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 10/19/2025
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Provider Practice Location Address
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Address Line | 9047 EXECUTIVE PARK DR STE 201
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City | KNOXVILLE
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State | TN
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Zip | 37923-4625
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Country | US
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Telephone | 865-424-6371
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Fax |
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Provider Business Mailing Address
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Address Line | 9047 EXECUTIVE PARK DR STE 201
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City | KNOXVILLE
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State | TN
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Zip | 37923-4625
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Country | US
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Telephone | 601-764-8603
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 8231
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License Number State | TN
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