Provider Demographics
NPI:1912224536
Name:FRANKEN, RITA T (LISW)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:T
Last Name:FRANKEN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 80 BOX 278
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-9596
Mailing Address - Country:US
Mailing Address - Phone:505-274-1920
Mailing Address - Fax:
Practice Address - Street 1:HC 80 BOX 278
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-9596
Practice Address - Country:US
Practice Address - Phone:505-274-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-06157101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health