Healthcare Provider Details

I. General information

NPI: 1770535361
Provider Name (Legal Business Name): FRANCES G. MARTIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 OLD YORK RD SUITE 110B
ELKINS PARK PA
19027-2318
US

IV. Provider business mailing address

7900 OLD YORK RD SUITE 110B
ELKINS PARK PA
19027-2318
US

V. Phone/Fax

Practice location:
  • Phone: 215-782-1250
  • Fax:
Mailing address:
  • Phone: 215-782-1250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS-006281-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: