Healthcare Provider Details

I. General information

NPI: 1154268498
Provider Name (Legal Business Name): SENETHEA FRAZIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3965 W 83RD ST STE 157
PRAIRIE VILLAGE KS
66208-5308
US

IV. Provider business mailing address

12315 CHEROKEE LN
LEAWOOD KS
66209-1437
US

V. Phone/Fax

Practice location:
  • Phone: 913-258-5322
  • Fax:
Mailing address:
  • Phone: 913-258-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: