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General NPI Number Information
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NPI Number | 1881560175
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Entity Type | Individual
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Provider Name | BETSY MARIE FREDERICK MMFT, LMFT ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 5310 E US HIGHWAY 377 STE 200
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City | GRANBURY
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State | TX
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Zip | 76049-7849
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Country | US
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Telephone | 325-244-8338
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 KAREN WAY
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City | GRANBURY
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State | TX
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Zip | 76049-2989
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 206054
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License Number State | TX
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