Provider Demographics
NPI:1417670191
Name:FRANKLIN, TERRIE L (MHPS, ADC, QPS)
Entity Type:Individual
Prefix:
First Name:TERRIE
Middle Name:L
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MHPS, ADC, QPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 CHEVY CHASE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1599
Mailing Address - Country:US
Mailing Address - Phone:512-939-8847
Mailing Address - Fax:
Practice Address - Street 1:6001 W PARMER LN STE 1027
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-3901
Practice Address - Country:US
Practice Address - Phone:512-939-8847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50117-0322261QR0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care