Healthcare Provider Details

I. General information

NPI: 1184106528
Provider Name (Legal Business Name): KIMBERLY ANN FROELICK MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2018
Last Update Date: 09/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 COUNTY ROAD 326
ADKINS TX
78101
US

IV. Provider business mailing address

1851 COUNTY ROAD 326
ADKINS TX
78101-2660
US

V. Phone/Fax

Practice location:
  • Phone: 210-316-5598
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: