Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 6575 | OH |
NPI | 1073585592 |
---|---|
Provider Name | Adrienne E Fricker-Elhai |
First Address | Toledo, OH 43606-3834 |
Second Address | Toledo, OH 43606-3834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 08/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040121002 | PRIMEWEST (01) | MN |
044G1EL | CC SYSTEMS/ BLUE PLUS (01) | MN |
12200 | (05) | ND |
1766590 | ARAZ/ AMERICA'S PPO (01) | SD |
238934 | MIDLANDS CHOICE (01) | SD |
28317 | SANFORD HEALTH PLAN (01) | SD |
370624200 | DEPT OF LABOR (01) | SD |
3989442 | (05) | IA |
412991032870 | PREFERRED ONE (01) | SD |
441 | DAKOTACARE (01) | SD |
46022474352 | (05) | NE |
483958700 | (05) | MN |
4996337 | BLUE CROSS (01) | SD |
57108C024 | WPS TRICARE (01) | SD |
6551990 | (05) | SD |
HP37521 | HEALTHPARTNERS (01) | SD |
P00013287 | RR MEDICARE (01) | SD |
P87526 | (02) | SD |