Provider Demographics
NPI:1285001800
Name:FRENTZ, LUANN
Entity Type:Individual
Prefix:MRS
First Name:LUANN
Middle Name:
Last Name:FRENTZ
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 1:44 S HOERNERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-9210
Mailing Address - Country:US
Mailing Address - Phone:717-756-8465
Mailing Address - Fax:
Practice Address - Street 1:44 S HOERNERSTOWN RD
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-9210
Practice Address - Country:US
Practice Address - Phone:717-756-8465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102745129OtherDEPARTMENT OF PUBLIC WELFARE/MEDICAL ASSISTANCE