Healthcare Provider Details

I. General information

NPI: 1730250507
Provider Name (Legal Business Name): ESTEBANIA LLADO-FRAZER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12086 WINFIELD RD
WINFIELD WV
25213-7902
US

IV. Provider business mailing address

12086 WINFIELD RD
WINFIELD WV
25213-7902
US

V. Phone/Fax

Practice location:
  • Phone: 304-800-7151
  • Fax:
Mailing address:
  • Phone: 304-800-7151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: