Provider Demographics
NPI:1396035911
Name:FRAZIER, EMILY DIANE (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:DIANE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8961 TWELVE CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:LASCASSAS
Mailing Address - State:TN
Mailing Address - Zip Code:37085-4437
Mailing Address - Country:US
Mailing Address - Phone:615-260-3883
Mailing Address - Fax:
Practice Address - Street 1:237 CASTLEWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-5166
Practice Address - Country:US
Practice Address - Phone:615-260-3883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000051601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical