Provider Demographics
NPI:1487261830
Name:FRANKLIN, ANGELA E
Entity type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:E
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12760 LEXINGTON RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-7646
Mailing Address - Country:US
Mailing Address - Phone:707-628-8456
Mailing Address - Fax:
Practice Address - Street 1:12760 LEXINGTON RIDGE ST
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7646
Practice Address - Country:US
Practice Address - Phone:707-628-8456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH18312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health