Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LASAC-15274 | AZ |
NPI | 1003467838 |
---|---|
Provider Name | Yotonya Rene Franklin |
First Address | Phoenix, AZ 85006-3019 |
Second Address | Phoenix, AZ 85034-1123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2019 |
Last Update Date | 23/09/2019 |