Provider Demographics
NPI:1114067634
Name:FRAJT, DANIEL MILTON (LPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MILTON
Last Name:FRAJT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 TOWNSHIP DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5243
Mailing Address - Country:US
Mailing Address - Phone:770-926-2768
Mailing Address - Fax:
Practice Address - Street 1:2026 TOWNSHIP DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5243
Practice Address - Country:US
Practice Address - Phone:770-926-2768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003169174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist