Provider Demographics
NPI:1164086898
Name:DRONE, FREDEREK JOE CHARLES
Entity Type:Individual
Prefix:
First Name:FREDEREK
Middle Name:JOE CHARLES
Last Name:DRONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 TENNESSEE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-4138
Mailing Address - Country:US
Mailing Address - Phone:913-710-6870
Mailing Address - Fax:
Practice Address - Street 1:1737 TENNESSEE ST APT 3
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-4138
Practice Address - Country:US
Practice Address - Phone:913-710-6870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst