Provider Demographics
NPI:1124303656
Name:FRANZEN, KATHLEEN ANNE (SLP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANNE
Last Name:FRANZEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7145 TURNER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5723
Mailing Address - Country:US
Mailing Address - Phone:321-622-8792
Mailing Address - Fax:321-622-8793
Practice Address - Street 1:7145 TURNER RD STE 101
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5723
Practice Address - Country:US
Practice Address - Phone:321-622-8792
Practice Address - Fax:321-622-8793
Is Sole Proprietor?:No
Enumeration Date:2011-10-16
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8642235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist