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Individual

DR. MONIQUE R FRAZIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
246 E 1260 N, LOGAN, UT 84341-7501
(435) 750-6300
(435) 753-8995
Mailing address
246 E 1260 N, PO BOX 6244, LOGAN, UT 84341-7501
(435) 750-6300
(435) 753-8995

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2797447-2501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107008963103
IHC
UT
01
27974472500001
REGENCE BXBS
UT
01
62617
PEHP
UT
01
825140
DMBA
UT
Enumeration date
03/13/2007
Last updated
07/08/2007
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