Provider Demographics
NPI:1003438318
Name:FRANZEN, SKYLER GRACE
Entity Type:Individual
Prefix:
First Name:SKYLER
Middle Name:GRACE
Last Name:FRANZEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 SIR LANCELOT CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7007
Mailing Address - Country:US
Mailing Address - Phone:518-948-9353
Mailing Address - Fax:
Practice Address - Street 1:11681 VOYAGER PKWY STE 150
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3864
Practice Address - Country:US
Practice Address - Phone:719-344-9342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0110910102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst