Provider Demographics
NPI:1679018980
Name:FRANDSEN, AMY (CSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FRANDSEN
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11893 N APOLLO WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3648
Mailing Address - Country:US
Mailing Address - Phone:801-661-0561
Mailing Address - Fax:
Practice Address - Street 1:1108 W SOUTH JORDAN PKWY STE B
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-5505
Practice Address - Country:US
Practice Address - Phone:801-661-0561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4883836-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical