Provider Demographics
NPI:1952718082
Name:FRAME, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:FRAME
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 1:1401 STANFORD DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3538
Mailing Address - Country:US
Mailing Address - Phone:330-319-3655
Mailing Address - Fax:
Practice Address - Street 1:1401 STANFORD DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3538
Practice Address - Country:US
Practice Address - Phone:330-319-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2711908Medicaid