MEDICARE: DR. FRANCES JULIENNE HASSELL PHD

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	103T00000X	Psychologist	631	GA

General Provider Information

NPI Number	:	1710097381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCES JULIENNE HASSELL PHD

Provider Business Mailing Address
First Line	:	2628 CLAIRMONT RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-2711
Country	:	US
Telephone Number	:	404-315-8262
Fax Number	:

Provider Business Practice Location Address
First Line	:	2628 CLAIRMONT RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-2711
Country	:	US
Telephone Number	:	404-315-8262
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	12/02/2013

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