Provider Demographics
NPI:1669915914
Name:IDE, FRANCES RENEE (MS, ED)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:RENEE
Last Name:IDE
Suffix:
Gender:F
Credentials:MS, ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BUFFALO ST
Mailing Address - Street 2:APT. 201
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-5022
Mailing Address - Country:US
Mailing Address - Phone:716-308-2528
Mailing Address - Fax:
Practice Address - Street 1:25 BUFFALO ST
Practice Address - Street 2:APT. 201
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-5022
Practice Address - Country:US
Practice Address - Phone:716-308-2528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY959012991235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist