Provider Demographics
NPI:1114217007
Name:FRATTOLILLO, LAURA MARIA (MSSA, LSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIA
Last Name:FRATTOLILLO
Suffix:
Gender:F
Credentials:MSSA, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 ALISON AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6165
Mailing Address - Country:US
Mailing Address - Phone:814-323-1185
Mailing Address - Fax:
Practice Address - Street 1:2170 W 32ND ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1952
Practice Address - Country:US
Practice Address - Phone:814-835-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW123777104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker