Provider Demographics
NPI:1275297319
Name:FRAZIER, ALEA GLORIA (LPC)
Entity Type:Individual
Prefix:
First Name:ALEA
Middle Name:GLORIA
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7971 TEMPLE RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-2115
Mailing Address - Country:US
Mailing Address - Phone:267-455-9513
Mailing Address - Fax:
Practice Address - Street 1:7971 TEMPLE RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-2115
Practice Address - Country:US
Practice Address - Phone:267-455-9513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013164101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional