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Lisa Fredrickson
Student in an Organized Health Care Education/Training Program in Windsor, Connecticut
NPI 1023576493

Lisa Fredrickson is a Student in an Organized Health Care Education/Training Program based in Westbrook, CT. Lisa Fredrickson practices in Windsor, CT. The NPI Number for Lisa Fredrickson is 1023576493 and holds a License No. 12734 (Connecticut).

The current practice location address for Lisa Fredrickson is 250 Lamberton Rd, Windsor, CT and can be reached out via phone at 860-688-3663.

Location: 250 Lamberton Rd, Windsor, CT, 06498-1458
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023576493
Provider Name
Lisa Fredrickson
Credential
Provider Entity Type
Individual
Gender
Female
Address
250 Lamberton Rd, Windsor, CT, 06498-1458
Phone Number
860-688-3663
Fax Number
Provider Enumeration Date
03/05/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
250 Lamberton Rd
City
Windsor
State
Connecticut
Zip
06095-2149
Phone Number
860-688-3663
Fax Number
person
Provider Business Mailing Address Details
Address
250 Lamberton Rd
City
Windsor
State
Connecticut
Zip
06095-2149
Phone Number
860-688-3663
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
()
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
12734 (Connecticut)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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