Individual
RACHEL MAE FONDREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, PIP
Contact information
Practice address
105 CHARGE CT APT 1F, ELIZABETHTOWN, KY 42701-4984
(256) 443-0992
Mailing address
105 CHARGE CT APT 1F, ELIZABETHTOWN, KY 42701-4984
(562) 443-0992
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
259888
KY
1041C0700X
Clinical Social Worker
Primary
3972C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330000014
—
AL
Enumeration date
08/20/2013
Last updated
09/18/2025
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