Provider Demographics
NPI:1336656404
Name:FRECHTTE, JENNIFER ANN DUPONT (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN DUPONT
Last Name:FRECHTTE
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 1:97 PITMAN RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2738
Mailing Address - Country:US
Mailing Address - Phone:401-617-2148
Mailing Address - Fax:
Practice Address - Street 1:2 REGENCY PLZ
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-3160
Practice Address - Country:US
Practice Address - Phone:401-421-1405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01667103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist