MEDICARE: NICOLE MARIE FRANGELLA MA

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
1	101YM0800X	Mental Health Counselor	R8498	OR

General Provider Information

NPI Number	:	1881478014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MARIE FRANGELLA MA

Provider Business Mailing Address
First Line	:	147 COMMERCIAL ST NE STE 117
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-3416
Country	:	US
Telephone Number	:	503-897-0834
Fax Number	:

Provider Business Practice Location Address
First Line	:	147 COMMERCIAL ST NE STE 117
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-3416
Country	:	US
Telephone Number	:	503-897-0834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	08/21/2023

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Directions to “ NICOLE MARIE FRANGELLA MA” Practice Location

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