Provider Demographics
NPI:1023161429
Name:FRANKS, STACEY COLETTE (MBS,LBP)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:COLETTE
Last Name:FRANKS
Suffix:
Gender:F
Credentials:MBS,LBP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N HIGH ST
Mailing Address - Street 2:P.O. BOX 516
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-2238
Mailing Address - Country:US
Mailing Address - Phone:580-298-5779
Mailing Address - Fax:580-298-6699
Practice Address - Street 1:301 N HIGH ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-2238
Practice Address - Country:US
Practice Address - Phone:580-298-5779
Practice Address - Fax:580-298-6699
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0276101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health