Provider Demographics
NPI:1710383708
Name:FREDENBURG, HILARY (MA, MT-BC)
Entity Type:Individual
Prefix:MS
First Name:HILARY
Middle Name:
Last Name:FREDENBURG
Suffix:
Gender:F
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 GREAT OAKS TRL
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-2435
Mailing Address - Country:US
Mailing Address - Phone:651-492-3399
Mailing Address - Fax:
Practice Address - Street 1:833 GREAT OAKS TRL
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-2435
Practice Address - Country:US
Practice Address - Phone:651-492-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist