Provider Demographics
NPI:1538805882
Name:FRANKLIN, SHURONDA
Entity type:Individual
Prefix:MS
First Name:SHURONDA
Middle Name:
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 1:10752 N 89TH PL STE B212
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6730
Mailing Address - Country:US
Mailing Address - Phone:832-422-0418
Mailing Address - Fax:
Practice Address - Street 1:10752 N 89TH PL STE B212
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6730
Practice Address - Country:US
Practice Address - Phone:832-422-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ106847Medicaid