Provider Demographics
NPI:1265756357
Name:FRIESENHAHN-SOLIZ, GRACE M
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:M
Last Name:FRIESENHAHN-SOLIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 MUECKE DR
Mailing Address - Street 2:
Mailing Address - City:KARNES CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78118-2626
Mailing Address - Country:US
Mailing Address - Phone:830-780-3070
Mailing Address - Fax:
Practice Address - Street 1:1019 B ST STE B
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-1967
Practice Address - Country:US
Practice Address - Phone:210-387-4072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX64231OtherLICENSED PROFESSIONAL COUNSELOR LICENSE #