Basic Information
Provider Information
NPI: 1255688420
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANK
FirstName: ESTHER
MiddleName: REGINA
NamePrefix:  
NameSuffix:  
Credential: LSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 S EDWIN C MOSES BLVD
Address2: FIRST FLOOR, NW BLDG
City: DAYTON
State: OH
PostalCode: 454173424
CountryCode: US
TelephoneNumber: 9372244646
FaxNumber: 9372768269
Practice Location
Address1: 601 S EDWIN C MOSES BLVD
Address2: FIRST FLOOR, NW BLDG
City: DAYTON
State: OH
PostalCode: 454173424
CountryCode: US
TelephoneNumber: 9372244646
FaxNumber: 9372768269
Other Information
ProviderEnumerationDate: 08/07/2012
LastUpdateDate: 08/07/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XS0014095OHY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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