Provider Demographics
NPI:1598713257
Name:FECHNAY, TERRI LEE J (PH,D)
Entity Type:Individual
Prefix:DR
First Name:TERRI LEE
Middle Name:J
Last Name:FECHNAY
Suffix:
Gender:F
Credentials:PH,D
Other - Prefix:DR
Other - First Name:TERRI LEE
Other - Middle Name:J
Other - Last Name:DEMOREST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:102 YORKSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2101
Mailing Address - Country:US
Mailing Address - Phone:215-957-1784
Mailing Address - Fax:
Practice Address - Street 1:907 EASTON RD
Practice Address - Street 2:SUITE A1
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2036
Practice Address - Country:US
Practice Address - Phone:215-957-1784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006904L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA768831Medicare UPIN