Provider Demographics
NPI:1932206620
Name:RISSMILLER, FRANCES R (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:R
Last Name:RISSMILLER
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 1:2301 E EVESHAM RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4501
Mailing Address - Country:US
Mailing Address - Phone:856-651-9800
Mailing Address - Fax:856-751-6502
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:SUITE 108
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-651-9800
Practice Address - Fax:856-751-6502
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00327600103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ789521Medicare ID - Type UnspecifiedPROVIDER ID NUMBER