MEDICARE: NOEL B FRAZIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	16308	AZ

General Provider Information

NPI Number	:	1043964968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOEL B FRAZIER

Provider Business Mailing Address
First Line	:	2533 W DARREL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-6457
Country	:	US
Telephone Number	:	516-983-6857
Fax Number	:

Provider Business Practice Location Address
First Line	:	2533 W DARREL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-6457
Country	:	US
Telephone Number	:	516-983-6857
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2022
Last Update Date	:	02/09/2022

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Directions to “ NOEL B FRAZIER ” Practice Location

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