Provider Demographics
NPI:1558173419
Name:FRANCILIEN, PATRICK
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:FRANCILIEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6537 PARNELL AVE
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-4006
Mailing Address - Country:US
Mailing Address - Phone:410-308-1302
Mailing Address - Fax:
Practice Address - Street 1:300 45TH ST S STE 318
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6511
Practice Address - Country:US
Practice Address - Phone:410-908-6385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1234103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily