MEDICARE: MS. TONYA DENISE FRAZIER M.A.

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	LC4196	MD

General Provider Information

NPI Number	:	1962762427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TONYA DENISE FRAZIER M.A.

Provider Business Mailing Address
First Line	:	7034 CARROLL AVE
Second Line	:	SUITE 1
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4434
Country	:	US
Telephone Number	:	443-433-8292
Fax Number	:

Provider Business Practice Location Address
First Line	:	7034 CARROLL AVE
Second Line	:	SUITE 1
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-4434
Country	:	US
Telephone Number	:	443-433-8292
Fax Number	:

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

Provider Enumeration Date	:	05/17/2012
Last Update Date	:	05/17/2012

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