Provider Demographics
NPI:1033188057
Name:DEFRANCE, EMILY A (PHD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:A
Last Name:DEFRANCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 WEST STREET
Mailing Address - Street 2:STE 29
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431
Mailing Address - Country:US
Mailing Address - Phone:603-357-1180
Mailing Address - Fax:603-357-1185
Practice Address - Street 1:222 WEST STREET
Practice Address - Street 2:STE 29
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431
Practice Address - Country:US
Practice Address - Phone:603-357-1180
Practice Address - Fax:603-357-1185
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHLP1071103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423535Medicaid
NHRE8249Medicare ID - Type Unspecified
NH30423535Medicaid