MEDICARE: MS. KAYLA JOY DONFRANCESCO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	PC009257	PA

General Provider Information

NPI Number	:	1134662273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAYLA JOY DONFRANCESCO LPC

Provider Business Mailing Address
First Line	:	353 NEW DEHAVEN ST
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2635
Country	:	US
Telephone Number	:	401-829-8266
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 W LANCASTER AVE
Second Line	:	SUITE 2
City	:	ARDMORE
State	:	PA
Zip	:	19003-1413
Country	:	US
Telephone Number	:	610-314-7996
Fax Number	:	570-371-0344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	11/21/2016

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