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NPI Code Detail

MEDICARE: MISS DOLORES LEOPOLD FREDERICKS

MEDICARE: MISS DOLORES LEOPOLD FREDERICKS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1750039046
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS DOLORES LEOPOLD FREDERICKS
Provider Business Mailing Address
First Line : 3800 VICTORY PKWY UNIT 1
Second Line :
City : CINCINNATI
State : OH
Zip : 45207-1092
Country : US
Telephone Number : 615-601-4495
Fax Number :
Provider Business Practice Location Address
First Line : 3800 VICTORY PKWY UNIT 1
Second Line :
City : CINCINNATI
State : OH
Zip : 45207-1092
Country : US
Telephone Number : 615-601-4495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2022
Last Update Date : 03/15/2022

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Directions to “ MISS DOLORES LEOPOLD FREDERICKS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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