MEDICARE: VERONICA FRAZIER LMFT, LPC

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	101YM0800X	Mental Health Counselor	202504	TX
2	101YM0800X	Mental Health Counselor	75189	TX

General Provider Information

NPI Number	:	1871152413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA FRAZIER LMFT, LPC

Provider Business Mailing Address
First Line	:	722 OAKBLUFF DR
Second Line	:
City	:	LANCASTER
State	:	TX
Zip	:	75146-1429
Country	:	US
Telephone Number	:	972-489-0119
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 TAPERWICKE DR
Second Line	:	UNIT 115
City	:	DALLAS
State	:	TX
Zip	:	75232-4609
Country	:	US
Telephone Number	:	972-489-0119
Fax Number	:

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

Provider Enumeration Date	:	06/07/2019
Last Update Date	:	05/30/2022

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