Provider Demographics
NPI:1588433411
Name:FROST, ANDRIANA (PSYD)
Entity type:Individual
Prefix:
First Name:ANDRIANA
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 PEQUEA AVE
Mailing Address - Street 2:
Mailing Address - City:GAP
Mailing Address - State:PA
Mailing Address - Zip Code:17527-9608
Mailing Address - Country:US
Mailing Address - Phone:570-850-3644
Mailing Address - Fax:
Practice Address - Street 1:4701 OGLETOWN STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2055
Practice Address - Country:US
Practice Address - Phone:302-366-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019894103T00000X, 103TC0700X
DEB1-0011431103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical