Provider Demographics
NPI:1912005356
Name:CHAVEZ-FRIGON, PENELOPE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PENELOPE
Middle Name:
Last Name:CHAVEZ-FRIGON
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 1:4605 PRIMER CT
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-1165
Mailing Address - Country:US
Mailing Address - Phone:513-943-4746
Mailing Address - Fax:
Practice Address - Street 1:551 BATAVIA PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-1518
Practice Address - Country:US
Practice Address - Phone:513-752-1555
Practice Address - Fax:513-753-2144
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6266103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical