Provider Demographics
NPI:1376764050
Name:MERVYN, FRANCES VERA (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:VERA
Last Name:MERVYN
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 1:59 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1806
Mailing Address - Country:US
Mailing Address - Phone:857-231-1513
Mailing Address - Fax:
Practice Address - Street 1:59 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1806
Practice Address - Country:US
Practice Address - Phone:857-231-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1613103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist