Healthcare Provider Details

I. General information

NPI: 1578939385
Provider Name (Legal Business Name): FRANCESCA HREZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2015
Last Update Date: 08/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 E CRAWFORD ST
ELKHART IN
46514-2713
US

IV. Provider business mailing address

221 E CRAWFORD ST
ELKHART IN
46514-2713
US

V. Phone/Fax

Practice location:
  • Phone: 574-262-3597
  • Fax:
Mailing address:
  • Phone: 574-262-3597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: