Provider Demographics
NPI:1437475159
Name:FRANKLIN, LISA ANN (BA CDPT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:BA CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-4817
Mailing Address - Country:US
Mailing Address - Phone:360-748-6696
Mailing Address - Fax:
Practice Address - Street 1:135 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-4817
Practice Address - Country:US
Practice Address - Phone:360-748-6696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2019-09-25
Deactivation Date:2019-07-23
Deactivation Code:
Reactivation Date:2019-09-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health