Provider Demographics
NPI:1942348487
Name:OELTJEN, FREDERICK JOHN (PHD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:JOHN
Last Name:OELTJEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 COURTHOUSE SQ
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2336
Mailing Address - Country:US
Mailing Address - Phone:301-424-6955
Mailing Address - Fax:301-424-4836
Practice Address - Street 1:20 COURTHOUSE SQ
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2336
Practice Address - Country:US
Practice Address - Phone:301-424-6955
Practice Address - Fax:301-424-4836
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01189103TC0700X
DCPSY964103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical