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General NPI Number Information
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NPI Number | 1205975141
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Entity Type | Organization
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Legal Business Name | JO FRAZER RN MS INC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3037 NW 63RD ST SUITE 153W
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-3635
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Country | US
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Telephone | 405-842-0634
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Fax | 405-842-4595
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Provider Business Mailing Address
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Address Line | 3037 NW 63RD ST SUITE 153W
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-3635
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Country | US
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Telephone | 405-842-0634
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Fax | 405-842-4595
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Authorized Official
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Title or Position | PRES
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Name | JO FRAZER
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Credential | RN MS
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Telephone | 405-842-0634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 534
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License Number State | OK
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