Provider Demographics
NPI:1619025103
Name:FRANKLIN, DORETHEA (BS, MS)
Entity Type:Individual
Prefix:MS
First Name:DORETHEA
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:BS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3317
Mailing Address - Country:US
Mailing Address - Phone:716-310-1339
Mailing Address - Fax:
Practice Address - Street 1:49 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3317
Practice Address - Country:US
Practice Address - Phone:716-310-1339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health