MEDICARE: MS. JENNIFER FRAZIER LMSW

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	101Y00000X	Counselor
2	171M00000X	Case Manager/Care Coordinator	60600	TX

General Provider Information

NPI Number	:	1821232240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER FRAZIER LMSW

Provider Business Mailing Address
First Line	:	4705 MONARCH DR
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-4925
Country	:	US
Telephone Number	:	214-298-1416
Fax Number	:	214-824-6504

Provider Business Practice Location Address
First Line	:	4705 MONARCH DR
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-4925
Country	:	US
Telephone Number	:	214-298-1416
Fax Number	:	214-824-6504

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

Provider Enumeration Date	:	04/29/2009
Last Update Date	:	07/21/2022

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