Provider Demographics
NPI:1447817549
Name:FREGIN, HOLLY (RMHCI)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:FREGIN
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 W CYPRESS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1756
Mailing Address - Country:US
Mailing Address - Phone:954-979-7911
Mailing Address - Fax:954-302-4960
Practice Address - Street 1:2717 W CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1756
Practice Address - Country:US
Practice Address - Phone:954-979-7911
Practice Address - Fax:954-302-4960
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health