Healthcare Provider Details

I. General information

NPI: 1184096430
Provider Name (Legal Business Name): SARAH FRAIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 N. CHARLES STREET
BALTIMORE MD
21218
US

IV. Provider business mailing address

2225 N CHARLES ST
BALTIMORE MD
21218-5778
US

V. Phone/Fax

Practice location:
  • Phone: 410-366-4360
  • Fax:
Mailing address:
  • Phone: 410-366-4360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number21100
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: