Provider Demographics
NPI:1437887650
Name:FRANKLIN, OLIVIA MONTAGNET (RBT)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MONTAGNET
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MRS
Other - First Name:OLIVIA
Other - Middle Name:MCCARLEY
Other - Last Name:MONTAGNET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1635 PIEDMONT ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-1342
Mailing Address - Country:US
Mailing Address - Phone:601-927-7129
Mailing Address - Fax:
Practice Address - Street 1:402B LEGACY PARK
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4315
Practice Address - Country:US
Practice Address - Phone:769-233-7154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSRBT-20-131222106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician