Basic Information
Provider Information
NPI: 1851839054
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANKENFIELD
FirstName: ASHLEY
MiddleName: LAUREN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7777 131ST ST STE 7
Address2:  
City: SEMINOLE
State: FL
PostalCode: 337764015
CountryCode: US
TelephoneNumber: 7274925369
FaxNumber: 7273503255
Practice Location
Address1: 104 SHOREVIEW LN
Address2:  
City: OLDSMAR
State: FL
PostalCode: 346774106
CountryCode: US
TelephoneNumber: 7274925369
FaxNumber: 8138180510
Other Information
ProviderEnumerationDate: 02/08/2017
LastUpdateDate: 06/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X1-21-50659FLY Behavioral Health & Social Service ProvidersBehavioral Analyst 
106S00000X  N    

No ID Information.


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