Healthcare Provider Details

I. General information

NPI: 1518296383
Provider Name (Legal Business Name): KRISTIN M FROEHLICH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 04/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 PASSMORE RD
WILMINGTON DE
19803
US

IV. Provider business mailing address

1515 EMORY RD
WILMINGTON DE
19803-5154
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-9411
  • Fax: 302-479-9883
Mailing address:
  • Phone: 302-379-0488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0000740
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW122371
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: