=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225022403
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCES BONDS-WHITE ED.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2005
-----------------------------------------------------
Last Update Date | 07/29/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2205 BAINBRIDGE ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19146-1130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-735-4393
-----------------------------------------------------
Fax | 215-735-3608
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2205 BAINBRIDGE ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19146-1130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-735-4393
-----------------------------------------------------
Fax | 215-735-3608
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PS015083
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------