Provider Demographics
NPI:1760469597
Name:SPICKERMAN, FRANCES A (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:A
Last Name:SPICKERMAN
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 1:566 S ODELL AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-2123
Mailing Address - Country:US
Mailing Address - Phone:660-886-7307
Mailing Address - Fax:660-886-7307
Practice Address - Street 1:566 S ODELL AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-2123
Practice Address - Country:US
Practice Address - Phone:660-886-7307
Practice Address - Fax:660-886-7307
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
21614033OtherBCBS
6149831OtherUBH
0006029AMedicare ID - Type Unspecified
6149831OtherUBH