MEDICARE: REBECCA L FRANKLIN 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
2	106S00000X	Behavior Technician
3	103K00000X	Behavior Analyst	1-21-47246	CO

General Provider Information

NPI Number	:	1194176826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA L FRANKLIN BCBA

Provider Business Mailing Address
First Line	:	685 BRIGGS ST
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-5022
Country	:	US
Telephone Number	:	720-848-2668
Fax Number	:

Provider Business Practice Location Address
First Line	:	685 BRIGGS ST
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-5022
Country	:	US
Telephone Number	:	720-849-2668
Fax Number	:

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

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	02/15/2021

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