Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | E0002243 | OH |
NPI | 1003343930 |
---|---|
Provider Name | Karen Fronczak |
First Address | Ashtabula, OH 44004-4577 |
Second Address | Ashtabula, OH 44004-4577 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2017 |
Last Update Date | 23/05/2017 |