Provider Demographics
NPI:1265661789
Name:FRAZIER, TRACEY DENISE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:DENISE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11063
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19850-1063
Mailing Address - Country:US
Mailing Address - Phone:302-377-9634
Mailing Address - Fax:
Practice Address - Street 1:32 BUENA VISTA DR
Practice Address - Street 2:ARBORS OF NEW CASTLE
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4660
Practice Address - Country:US
Practice Address - Phone:302-328-2580
Practice Address - Fax:302-326-4132
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECD-0000030101YA0400X
DEB1-0000747103TC0700X
DEQ1-00006251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical