Provider Demographics
NPI:1396819298
Name:MONTAGNOLO, FRANCINE MERCEDES (PSYD)
Entity Type:Individual
Prefix:
First Name:FRANCINE
Middle Name:MERCEDES
Last Name:MONTAGNOLO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 W CHESTER PIKE STE D2
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7783
Mailing Address - Country:US
Mailing Address - Phone:610-692-2092
Mailing Address - Fax:
Practice Address - Street 1:1515 W CHESTER PIKE STE D2
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7783
Practice Address - Country:US
Practice Address - Phone:610-692-2092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008760L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist