MEDICARE: MISS TAYLOR CHRISTINE FROLING RC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	CG60485223	WA
2	101YP2500X	Professional Counselor	RC00056978	WA
3	101YM0800X	Mental Health Counselor	MC60967843	WA

General Provider Information

NPI Number	:	1457554453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TAYLOR CHRISTINE FROLING RC

Provider Business Mailing Address
First Line	:	2204 WINDSOR DR
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-5673
Country	:	US
Telephone Number	:	360-630-7756
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 ROOSEVELT AVE STE 2
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-2687
Country	:	US
Telephone Number	:	360-939-1450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	12/29/2020

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