Provider Demographics
NPI:1346532892
Name:DERRY, FRANCELIA (M DIV)
Entity Type:Individual
Prefix:
First Name:FRANCELIA
Middle Name:
Last Name:DERRY
Suffix:
Gender:F
Credentials:M DIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 W 9TH ST
Mailing Address - Street 2:4TH FLOOR D&A RECOVERY
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-2040
Mailing Address - Country:US
Mailing Address - Phone:610-497-7200
Mailing Address - Fax:610-497-7244
Practice Address - Street 1:2600 W 9TH ST
Practice Address - Street 2:4TH FLOOR D&A RECOVERY
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-2040
Practice Address - Country:US
Practice Address - Phone:610-497-7200
Practice Address - Fax:610-497-7244
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)