NPI 1003042151

Fredericka C Wilfong, MDIV

Practitioner Counselor Maitland, FL

Practice location

Address: 1009 Maitland Center Commons Blvd Suite 212, Maitland, FL 32751-7270
Phone: (800) 840-2528
Mailing address: 7729 Pineapple Dr, Orlando, FL 32835-5311

Registered specialties

Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101Y00000X Licence IMT2141 (FL)

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Registry record

NPI: 1003042151
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Jun 2009
Record last updated: 19 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.