Provider Demographics
NPI:1750552659
Name:FANELLI-NOLA, ANDREA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:FANELLI-NOLA
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 1:33 S DELAWARE AVE
Mailing Address - Street 2:RIVERVIEW PLAZA, SUITE 106B
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1524
Mailing Address - Country:US
Mailing Address - Phone:215-595-5834
Mailing Address - Fax:
Practice Address - Street 1:33 S DELAWARE AVE
Practice Address - Street 2:RIVERVIEW PLAZA, SUITE 106B
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1524
Practice Address - Country:US
Practice Address - Phone:215-595-5834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016371103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical