Provider Demographics
NPI:1134704513
Name:FREHNER, PAULA KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:KAY
Last Name:FREHNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:KAY
Other - Last Name:HEDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, MED
Mailing Address - Street 1:1418 SWEETWATER CIR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6182
Mailing Address - Country:US
Mailing Address - Phone:435-817-6077
Mailing Address - Fax:
Practice Address - Street 1:630 S 400 E STE 103
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3765
Practice Address - Country:US
Practice Address - Phone:435-817-6077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11295949-35011041C0700X
UT11295949-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1134704513Medicaid