Provider Demographics
NPI:1568244473
Name:FRAZIER, IVIE
Entity Type:Individual
Prefix:
First Name:IVIE
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 1:2502 BLYTHEWOOD CROSSING LANE
Mailing Address - Street 2:APT. 1925
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016
Mailing Address - Country:US
Mailing Address - Phone:478-284-6197
Mailing Address - Fax:
Practice Address - Street 1:2502 BLYTHEWOOD CROSSING LANE
Practice Address - Street 2:APT. 1925
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-2901
Practice Address - Country:US
Practice Address - Phone:478-284-6197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC84962355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty