Basic Information
| Provider Information | |||||||||
| NPI: | 1912591579 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRAHM | ||||||||
| FirstName: | RENEE | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 WELLNESS DR | ||||||||
| Address2: | |||||||||
| City: | MIDLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486702000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8448321956 | ||||||||
| FaxNumber: | 9896335241 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 CAMPUS RIDGE DR STE 1100 | ||||||||
| Address2: | |||||||||
| City: | MIDLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486406125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898379200 | ||||||||
| FaxNumber: | 9898379205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2021 | ||||||||
| LastUpdateDate: | 02/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6801108713 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.