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NPI Code Detail

MEDICARE: KRISTIN L FRITH REHAB SPEC

MEDICARE: KRISTIN L FRITH REHAB SPEC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1629191671
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN L FRITH REHAB SPEC
Provider Business Mailing Address
First Line : PO BOX 1106
Second Line :
City : UKIAH
State : CA
Zip : 95482-1106
Country : US
Telephone Number : 707-467-1965
Fax Number :
Provider Business Practice Location Address
First Line : 6150 ORR SPRINGS RD
Second Line :
City : UKIAH
State : CA
Zip : 95482-9032
Country : US
Telephone Number : 707-462-5056
Fax Number : 707-462-5205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 07/08/2007

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