Provider Demographics
NPI:1689312142
Name:FRAZER, MEGAN E (APC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:FRAZER
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 AUBURN AVE NE APT 228
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1980
Mailing Address - Country:US
Mailing Address - Phone:678-249-0883
Mailing Address - Fax:
Practice Address - Street 1:659 AUBURN AVE NE APT 228
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1980
Practice Address - Country:US
Practice Address - Phone:404-775-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006862101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor