Provider Demographics
NPI:1801013776
Name:FRASER, KARI (PHD)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:
Last Name:FRASER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 PENROSE PL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1818
Mailing Address - Country:US
Mailing Address - Phone:303-443-3487
Mailing Address - Fax:
Practice Address - Street 1:3405 PENROSE PL
Practice Address - Street 2:SUITE 203
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1818
Practice Address - Country:US
Practice Address - Phone:303-443-3487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2232103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical