MEDICARE: JENNIFERANN FRAZIER

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	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1427549740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFERANN FRAZIER

Provider Business Mailing Address
First Line	:	3158 ORANGEWOOD LN
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5181
Country	:	US
Telephone Number	:	702-487-1479
Fax Number	:

Provider Business Practice Location Address
First Line	:	511 N LAMB BLVD APT 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3362
Country	:	US
Telephone Number	:	702-587-2309
Fax Number	:

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

Provider Enumeration Date	:	05/22/2018
Last Update Date	:	05/22/2018

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Directions to “ JENNIFERANN FRAZIER ” Practice Location

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