Provider Demographics
NPI:1346321908
Name:FREDERICK, ALICE HAND (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:HAND
Last Name:FREDERICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 FAIRHOPE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-2313
Mailing Address - Country:US
Mailing Address - Phone:251-990-5675
Mailing Address - Fax:251-990-5675
Practice Address - Street 1:131 FAIRHOPE AVE
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-2313
Practice Address - Country:US
Practice Address - Phone:251-990-5675
Practice Address - Fax:251-990-5675
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL129106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist