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General NPI Number Information
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NPI Number | 1417973991
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Entity Type | Individual
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Provider Name | DEBORAH ANN FRASER LPC
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Gender | Female
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1189 TIBWIN RD
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City | MC CLELLANVILLE
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State | SC
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Zip | 29458-9405
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Country | US
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Telephone | 843-887-3274
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Fax | 843-887-3817
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Provider Business Mailing Address
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Address Line | PO BOX 608
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City | MC CLELLANVILLE
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State | SC
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Zip | 29458-0608
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Country | US
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Telephone | 843-887-3274
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Fax | 843-887-3817
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5152
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License Number State |
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