Provider Demographics
NPI:1871359059
Name:FROBERG, CONSTANCE M (LMFT-A)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:M
Last Name:FROBERG
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 VANGUARD CT
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-8800
Mailing Address - Country:US
Mailing Address - Phone:817-266-8174
Mailing Address - Fax:
Practice Address - Street 1:7301 VANGUARD CT
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-8800
Practice Address - Country:US
Practice Address - Phone:817-266-8174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205260106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist