Provider Demographics
NPI:1932454659
Name:FRAZIER, SHAMPREE NICOLE
Entity Type:Individual
Prefix:
First Name:SHAMPREE
Middle Name:NICOLE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12060 MAGAZINE ST APT 5201
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-5520
Mailing Address - Country:US
Mailing Address - Phone:407-409-1724
Mailing Address - Fax:
Practice Address - Street 1:12060 MAGAZINE ST APT 5201
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-5520
Practice Address - Country:US
Practice Address - Phone:407-409-1724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor