Healthcare Provider Details

I. General information

NPI: 1568938082
Provider Name (Legal Business Name): SAVANNAH FOREVER FRAUNFELTER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAVANNAH RODRIGUEZ

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 N DIXIE HWY STE 2
MONROE MI
48162-5231
US

IV. Provider business mailing address

1645 N DIXIE HWY STE 2
MONROE MI
48162-5231
US

V. Phone/Fax

Practice location:
  • Phone: 734-344-7432
  • Fax: 734-344-7431
Mailing address:
  • Phone: 734-344-7432
  • Fax: 734-344-7431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801121853
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: