Provider Demographics
NPI:1629624697
Name:FRANKLIN, MERIT (OTR/L)
Entity Type:Individual
Prefix:
First Name:MERIT
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MARIA DR APT 225
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-3598
Mailing Address - Country:US
Mailing Address - Phone:469-682-4464
Mailing Address - Fax:
Practice Address - Street 1:55 MARIA DR APT 225
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-3598
Practice Address - Country:US
Practice Address - Phone:469-682-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20323225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist