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NPI Code Detail

MEDICARE: AMINA FRAZIER-BROOKS LCDC III

MEDICARE: AMINA FRAZIER-BROOKS LCDC III
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCDCIII.161520OH

General Provider Information

NPI Number : 1053800896
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMINA FRAZIER-BROOKS LCDC III
Provider Business Mailing Address
First Line : 151 E EUREKA ST
Second Line :
City : LIMA
State : OH
Zip : 45804-1315
Country : US
Telephone Number : 419-204-9931
Fax Number :
Provider Business Practice Location Address
First Line : 2727 SAINT JOHNS RD STE D
Second Line :
City : LIMA
State : OH
Zip : 45804-4029
Country : US
Telephone Number : 567-940-9145
Fax Number : 567-940-9803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2018
Last Update Date : 05/08/2018

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Directions to “ AMINA FRAZIER-BROOKS LCDC III” Practice Location

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