MEDICARE: SUSAN FRENSLEY PHD & ASSOCIATES INC.

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	103TC0700X	Clinical Psychologist	34188	TX

General Provider Information

NPI Number	:	1326339508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSAN FRENSLEY PHD & ASSOCIATES INC.

Provider Business Mailing Address
First Line	:	PO BOX 955
Second Line	:
City	:	CAMERON
State	:	TX
Zip	:	76520-0955
Country	:	US
Telephone Number	:	830-637-9615
Fax Number	:	972-852-7992

Provider Business Practice Location Address
First Line	:	704 N CROCKETT AVE
Second Line	:
City	:	CAMERON
State	:	TX
Zip	:	76520-2551
Country	:	US
Telephone Number	:	830-637-9615
Fax Number	:	972-852-7992

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SUSAN FRENSLEY
Credential	:	PHD
Telephone Number	:	830-637-9615

Provider Enumeration Date	:	04/22/2011
Last Update Date	:	04/22/2011

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