Provider Demographics
NPI:1437356698
Name:FRAZIER, TAMYR REBECCA (PSYS)
Entity Type:Individual
Prefix:MRS
First Name:TAMYR
Middle Name:REBECCA
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4987 GOGGINS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8505
Mailing Address - Country:US
Mailing Address - Phone:859-626-9191
Mailing Address - Fax:859-626-9191
Practice Address - Street 1:4987 GOGGINS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8505
Practice Address - Country:US
Practice Address - Phone:859-626-9191
Practice Address - Fax:859-626-9191
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool