Provider Demographics
NPI:1568618684
Name:FRANKS, RODERICK WAYNE (MA)
Entity Type:Individual
Prefix:
First Name:RODERICK
Middle Name:WAYNE
Last Name:FRANKS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2102
Mailing Address - Country:US
Mailing Address - Phone:952-442-3008
Mailing Address - Fax:952-442-3084
Practice Address - Street 1:600 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2102
Practice Address - Country:US
Practice Address - Phone:952-442-3008
Practice Address - Fax:952-442-3084
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3437103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist