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NPI Code Detail

MEDICARE: MRS. ASHLEY FEDRICK I LPC

MEDICARE:  MRS. ASHLEY  FEDRICK I LPC
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
1101YM0800XMental Health Counselor69147TX

General Provider Information

NPI Number : 1407284300
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY FEDRICK I LPC
Provider Business Mailing Address
First Line : 3355 BEE CAVES RD STE 508
Second Line :
City : WEST LAKE HILLS
State : TX
Zip : 78746-6682
Country : US
Telephone Number : 512-632-6448
Fax Number :
Provider Business Practice Location Address
First Line : 3355 BEE CAVES RD STE 508
Second Line :
City : WEST LAKE HILLS
State : TX
Zip : 78746-6682
Country : US
Telephone Number : 512-632-6448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2013
Last Update Date : 10/31/2013

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Directions to “ MRS. ASHLEY FEDRICK I LPC” Practice Location

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