MEDICARE: MRS. NICOLE LYNN FRANK MA, BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-09-5802	CA

General Provider Information

NPI Number	:	1760630297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICOLE LYNN FRANK MA, BCBA

Provider Business Mailing Address
First Line	:	2303 E. DARTMOUTH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80113
Country	:	US
Telephone Number	:	812-219-3073
Fax Number	:

Provider Business Practice Location Address
First Line	:	2303 E. DARTMOUTH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80113
Country	:	US
Telephone Number	:	812-219-3073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	09/27/2011

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