Provider Demographics
NPI:1003387036
Name:FRAZIER, SCHANTE YOLANDA (MA)
Entity Type:Individual
Prefix:
First Name:SCHANTE
Middle Name:YOLANDA
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-1312
Mailing Address - Country:US
Mailing Address - Phone:267-475-5098
Mailing Address - Fax:
Practice Address - Street 1:3114 N 24TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-1312
Practice Address - Country:US
Practice Address - Phone:267-475-5098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor