Provider Demographics
NPI:1639636244
Name:FRANCISCO, TARANNA L (LSW)
Entity Type:Individual
Prefix:
First Name:TARANNA
Middle Name:L
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2658 GILBERT AVE NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-4642
Mailing Address - Country:US
Mailing Address - Phone:330-327-9304
Mailing Address - Fax:
Practice Address - Street 1:5860 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-1752
Practice Address - Country:US
Practice Address - Phone:330-491-4331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1200707101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health