Provider Demographics
NPI:1265668388
Name:FRASIER, DANA N (MED)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:N
Last Name:FRASIER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 HEATHROW DR
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-9477
Mailing Address - Country:US
Mailing Address - Phone:912-572-2390
Mailing Address - Fax:
Practice Address - Street 1:1930 HEATHROW DR
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-9477
Practice Address - Country:US
Practice Address - Phone:912-572-2390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005412101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional