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General NPI Number Information
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NPI Number | 1417498312
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Entity Type | Organization
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Legal Business Name | M FRIERSON LLC
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 11911 LARCHMERE BLVD
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City | CLEVELAND
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State | OH
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Zip | 44120-1134
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Country | US
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Telephone | 216-773-4490
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Fax |
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Provider Business Mailing Address
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Address Line | 11911 LARCHMERE BLVD
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City | CLEVELAND
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State | OH
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Zip | 44120-1134
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Country | US
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Telephone | 216-773-4490
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. ME'CHELE D FRIERSON
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Credential | LISW-S
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Telephone | 216-773-4490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1140500.S
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License Number State | OH
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