Provider Demographics
NPI:1639741390
Name:FRISCH, DANIEL (PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FRISCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N4232 COUNTY ROAD D
Mailing Address - Street 2:
Mailing Address - City:OAKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53065-9788
Mailing Address - Country:US
Mailing Address - Phone:954-205-1901
Mailing Address - Fax:
Practice Address - Street 1:N4232 COUNTY ROAD D
Practice Address - Street 2:
Practice Address - City:OAKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53065-9788
Practice Address - Country:US
Practice Address - Phone:954-205-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3587-57103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist