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General NPI Number Information
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NPI Number | 1396035911
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Entity Type | Individual
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Provider Name | EMILY DIANE FRAZIER LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/15/2011
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 237 CASTLEWOOD DR STE A
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City | MURFREESBORO
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State | TN
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Zip | 37129-5166
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Country | US
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Telephone | 615-260-3883
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Fax |
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Provider Business Mailing Address
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Address Line | 8961 TWELVE CORNERS RD
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City | LASCASSAS
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State | TN
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Zip | 37085-4437
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Country | US
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Telephone | 615-260-3883
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW0000005160
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License Number State | TN
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