Provider Demographics
NPI:1841816659
Name:FRANKLIN, DEVIN MATTHEW (PC)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:MATTHEW
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 W FLORIST AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-3800
Mailing Address - Country:US
Mailing Address - Phone:414-247-0801
Mailing Address - Fax:141-247-0816
Practice Address - Street 1:1720 W FLORIST AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-3800
Practice Address - Country:US
Practice Address - Phone:414-247-0801
Practice Address - Fax:141-247-0816
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional