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General NPI Number Information
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NPI Number | 1942752589
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Entity Type | Individual
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Provider Name | TARA MARIE FRENI LLMFT, LLPC
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Gender | Female
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 120 FLINT RD
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City | BRIGHTON
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State | MI
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Zip | 48116-1112
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Country | US
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Telephone | 810-638-3603
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Fax |
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Provider Business Mailing Address
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Address Line | 4097 ASH TREE LN
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City | HOWELL
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State | MI
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Zip | 48843-8063
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Country | US
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Telephone | 517-672-0529
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401015712
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101006706
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License Number State | MI
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