Healthcare Provider Details

I. General information

NPI: 1093075616
Provider Name (Legal Business Name): SHELLEY L. FROEHLICH BHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 05/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 SWEDEN ST SUITE 201
CARIBOU ME
04736-2127
US

IV. Provider business mailing address

24 SWEDEN ST SUITE 201
CARIBOU ME
04736-2127
US

V. Phone/Fax

Practice location:
  • Phone: 207-493-3361
  • Fax: 207-492-4889
Mailing address:
  • Phone: 207-493-3361
  • Fax: 207-492-4889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: