Provider Demographics
NPI:1801130430
Name:FRANKLIN, MICHAEL ANTONI (MS,CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:MICHAEL
Middle Name:ANTONI
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MS,CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. DRAWER 2109
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-2109
Mailing Address - Country:US
Mailing Address - Phone:479-968-2322
Mailing Address - Fax:479-967-2876
Practice Address - Street 1:212 S LINCOLN ST STE A
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-9722
Practice Address - Country:US
Practice Address - Phone:479-770-0744
Practice Address - Fax:479-770-0176
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8592235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR193748721Medicaid