Provider Demographics
NPI:1962855353
Name:FRANKLIN, LATOYA ROSELLE (CM)
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:ROSELLE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:CM
Other - Prefix:MRS
Other - First Name:TOYA
Other - Middle Name:ROSELLE
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CM
Mailing Address - Street 1:14741 AGNES AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-2881
Mailing Address - Country:US
Mailing Address - Phone:586-222-5196
Mailing Address - Fax:586-408-6000
Practice Address - Street 1:23705 SHAKESPEARE AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-1719
Practice Address - Country:US
Practice Address - Phone:586-222-5196
Practice Address - Fax:586-349-6008
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI19167684171W00000X
171M00000X, 343900000X, 347C00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle