Provider Demographics
NPI:1487166104
Name:FRANCIS, EARTHA LAURENCIA
Entity type:Individual
Prefix:
First Name:EARTHA
Middle Name:LAURENCIA
Last Name:FRANCIS
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 1:280 E 95TH ST # 1R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-1945
Mailing Address - Country:US
Mailing Address - Phone:347-627-1702
Mailing Address - Fax:
Practice Address - Street 1:280 E 95TH ST # 1R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-1945
Practice Address - Country:US
Practice Address - Phone:347-627-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor