Provider Demographics
NPI:1174684039
Name:FRECHETTE, SUSAN ELIZABETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:FRECHETTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 917
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-0917
Mailing Address - Country:US
Mailing Address - Phone:726-610-0469
Mailing Address - Fax:210-729-1889
Practice Address - Street 1:10526 WIND WALKER
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-3851
Practice Address - Country:US
Practice Address - Phone:726-610-0469
Practice Address - Fax:210-729-1889
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10703225100000X
TX1330318225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist