Healthcare Provider Details

I. General information

NPI: 1558290213
Provider Name (Legal Business Name): CAMILLE FRAZER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3612 W PECOS RD
CHANDLER AZ
85226-4970
US

IV. Provider business mailing address

3612 W PECOS RD
CHANDLER AZ
85226-4970
US

V. Phone/Fax

Practice location:
  • Phone: 480-452-9570
  • Fax:
Mailing address:
  • Phone: 480-452-9570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code224ZF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapy Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name: CAMILLE FRAZER
Title or Position: OWNER
Credential:
Phone: 480-452-9570