Provider Demographics
NPI:1811269053
Name:FRAZIER, LAURA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 N MAIN ST
Mailing Address - Street 2:STE D
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1919
Mailing Address - Country:US
Mailing Address - Phone:254-773-6787
Mailing Address - Fax:
Practice Address - Street 1:2170 N MAIN ST
Practice Address - Street 2:STE D
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1919
Practice Address - Country:US
Practice Address - Phone:254-773-6787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist