Provider Demographics
NPI:1487193835
Name:FRAZIER, LATHRICIA
Entity Type:Individual
Prefix:
First Name:LATHRICIA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 STRATTON AVE
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-8204
Mailing Address - Country:US
Mailing Address - Phone:352-223-8922
Mailing Address - Fax:
Practice Address - Street 1:1155 STRATTON AVE
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-8204
Practice Address - Country:US
Practice Address - Phone:352-223-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No252Y00000XAgenciesEarly Intervention Provider Agency