Provider Demographics
NPI:1174744700
Name:SUTHERLAND, FRANCES COOLIDGE (PHD)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:COOLIDGE
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HIGHVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3703
Mailing Address - Country:US
Mailing Address - Phone:610-254-0047
Mailing Address - Fax:610-254-0993
Practice Address - Street 1:14 ELLIOTT AVENUE, SUITE 6
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3304
Practice Address - Country:US
Practice Address - Phone:610-527-9662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005904-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist