Provider Demographics
NPI:1316703358
Name:FRANKEN, JACQUELINEE ANN MARIE (LMT)
Entity type:Individual
Prefix:MS
First Name:JACQUELINEE
Middle Name:ANN MARIE
Last Name:FRANKEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:JACQUELINEE
Other - Middle Name:ANN MARIE
Other - Last Name:PRIETO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:2312 S MOCKINGBIRD CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-4425
Mailing Address - Country:US
Mailing Address - Phone:605-651-9313
Mailing Address - Fax:
Practice Address - Street 1:6705 W 41ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-1290
Practice Address - Country:US
Practice Address - Phone:605-929-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
SD11457225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness Coach