=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487882908
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JILL CHRISTINE FRANK M.A.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2009
-----------------------------------------------------
Last Update Date | 02/02/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4301 BENJAMIN ST NE
-----------------------------------------------------
City | COLUMBIA HEIGHTS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55421-3300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-317-9355
-----------------------------------------------------
Fax | 612-329-0023
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1774 GRAMSIE RD
-----------------------------------------------------
City | ARDEN HILLS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55112-2821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-341-7467
-----------------------------------------------------
Fax | 612-329-0023
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------