Provider Demographics
NPI:1417224718
Name:FRANCKHAUSER, JANE (MED, PCC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:FRANCKHAUSER
Suffix:
Gender:F
Credentials:MED, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5228
Mailing Address - Country:US
Mailing Address - Phone:419-874-0274
Mailing Address - Fax:419-874-9960
Practice Address - Street 1:975 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5228
Practice Address - Country:US
Practice Address - Phone:419-874-0274
Practice Address - Fax:419-874-9960
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0008452101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health