Basic Information
| Provider Information | |||||||||
| NPI: | 1518464130 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FREY | ||||||||
| FirstName: | MARGOT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3940 | ||||||||
| Address2: | |||||||||
| City: | QUINCY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302833330 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 PALM AVE | ||||||||
| Address2: | |||||||||
| City: | LODI | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093330971 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2018 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 225C00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Counselor |
No ID Information.