Provider Demographics
NPI:1427456474
Name:FRENTZ, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:FRENTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 VILLAGE DR
Mailing Address - Street 2:UNIT 106
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-8131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1774 CENTRE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57703-4029
Practice Address - Country:US
Practice Address - Phone:605-716-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist