Provider Demographics
NPI:1376283002
Name:UNIQUE NICHE LLC
Entity Type:Organization
Organization Name:UNIQUE NICHE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATHRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-640-0845
Mailing Address - Street 1:515 BELLISSIMO PL
Mailing Address - Street 2:
Mailing Address - City:HOWEY IN THE HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34737-0020
Mailing Address - Country:US
Mailing Address - Phone:407-640-0845
Mailing Address - Fax:
Practice Address - Street 1:515 BELLISSIMO PL
Practice Address - Street 2:
Practice Address - City:HOWEY IN THE HILLS
Practice Address - State:FL
Practice Address - Zip Code:34737-0020
Practice Address - Country:US
Practice Address - Phone:407-640-0845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty