Provider Demographics
NPI:1265075055
Name:BUTAHE, FRANKLIN ROBERT
Entity type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:ROBERT
Last Name:BUTAHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 RADCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-6112
Mailing Address - Country:US
Mailing Address - Phone:617-690-9420
Mailing Address - Fax:
Practice Address - Street 1:21 RADCLIFFE RD
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-6112
Practice Address - Country:US
Practice Address - Phone:617-690-9420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor