Provider Demographics
NPI:1558026450
Name:FRAUNCES, JOHN PHILLIP (EDD PSYCHOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PHILLIP
Last Name:FRAUNCES
Suffix:
Gender:M
Credentials:EDD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 KENT ROAD
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008
Mailing Address - Country:US
Mailing Address - Phone:610-446-0226
Mailing Address - Fax:
Practice Address - Street 1:310 KENT ROAD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008
Practice Address - Country:US
Practice Address - Phone:610-446-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-003593-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist