Provider Demographics
NPI:1609091420
Name:FRAZIER, MONICA FAYE (OTR)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:FAYE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 SW KENWILL DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-1445
Mailing Address - Country:US
Mailing Address - Phone:816-537-4319
Mailing Address - Fax:
Practice Address - Street 1:2404 SW KENWILL DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64082-1445
Practice Address - Country:US
Practice Address - Phone:816-537-4319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002023671225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist