Provider Demographics
NPI:1164839627
Name:FRANKLIN, LISA (BS)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3771 SW 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5556
Mailing Address - Country:US
Mailing Address - Phone:954-394-6803
Mailing Address - Fax:
Practice Address - Street 1:3771 SW 47TH AVE
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-5556
Practice Address - Country:US
Practice Address - Phone:954-394-6803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health