Provider Demographics
NPI:1902145923
Name:FRATZOLA, ROBERTA ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:ANN
Last Name:FRATZOLA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 POCONO BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT POCONO
Mailing Address - State:PA
Mailing Address - Zip Code:18344-1678
Mailing Address - Country:US
Mailing Address - Phone:570-476-7704
Mailing Address - Fax:570-421-3600
Practice Address - Street 1:1385 POCONO BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT POCONO
Practice Address - State:PA
Practice Address - Zip Code:18344-1678
Practice Address - Country:US
Practice Address - Phone:570-476-7704
Practice Address - Fax:570-421-3600
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional