Provider Demographics
NPI:1144344334
Name:FRANKLIN, JENNIFER (PHD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20310 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4913
Mailing Address - Country:US
Mailing Address - Phone:216-491-9405
Mailing Address - Fax:216-491-8025
Practice Address - Street 1:20310 CHAGRIN BLVD
Practice Address - Street 2:STE 2
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-4913
Practice Address - Country:US
Practice Address - Phone:216-491-9405
Practice Address - Fax:216-491-8025
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH#5113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH047460Medicare PIN