Provider Demographics
NPI:1215298336
Name:FREHNER, PAUL WALTER (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WALTER
Last Name:FREHNER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1238
Mailing Address - Country:US
Mailing Address - Phone:603-831-6310
Mailing Address - Fax:
Practice Address - Street 1:174 CONCORD ST
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1238
Practice Address - Country:US
Practice Address - Phone:603-831-6310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH#823103TC0700X
NH823103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent