Healthcare Provider Details

I. General information

NPI: 1710323431
Provider Name (Legal Business Name): WILLIAM SMITH FROILAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24100 CHAGRIN BLVD SUITE 400
BEACHWOOD OH
44122-5535
US

IV. Provider business mailing address

25700 SCIENCE PARK DRIVE. LANDMARK CENTRE. SUITE 200
BEACHWOOD OH
44122
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-1040
  • Fax: 216-831-2667
Mailing address:
  • Phone: 216-831-1040
  • Fax: 216-831-2667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7019
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: