Provider Demographics
NPI:1609132497
Name:UNKRAZEE :-) LLC
Entity Type:Organization
Organization Name:UNKRAZEE :-) LLC
Other - Org Name:EQUILIBRIUM ART THERAPY. COUNSELING. CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZEE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ATR-BC, CTT, LPC
Authorized Official - Phone:724-550-4004
Mailing Address - Street 1:108 MORGANTOWN ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4214
Mailing Address - Country:US
Mailing Address - Phone:724-550-4004
Mailing Address - Fax:
Practice Address - Street 1:108 MORGANTOWN ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4214
Practice Address - Country:US
Practice Address - Phone:724-550-4004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005440101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty