Provider Demographics
NPI:1538786959
Name:FRANKLIN, MAGGIE (BCBA)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 HUDSON LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-6003
Mailing Address - Country:US
Mailing Address - Phone:318-322-6500
Mailing Address - Fax:
Practice Address - Street 1:1300 HUDSON LN STE 8
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6054
Practice Address - Country:US
Practice Address - Phone:318-582-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-20-41270103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-20-41270OtherBCBA CERTIFICATE