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General NPI Number Information
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NPI Number | 1235056086
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Entity Type | Individual
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Provider Name | JACOB WESLEY FRAZIER
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Gender | Male
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 4101 BIRNEY AVE
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City | MOOSIC
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State | PA
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Zip | 18507-1323
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Country | US
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Telephone | 570-961-3361
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Fax |
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Provider Business Mailing Address
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Address Line | 901 HENRY ST
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City | ARCHBALD
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State | PA
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Zip | 18403-1954
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Country | US
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Telephone | 570-904-4431
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | PA
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