Individual
KEITH FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7905 N MEADOWLARK WAY STE C, COEUR D ALENE, ID 83815-5041
(208) 449-0204
Mailing address
9790 N EILEEN CT, HAYDEN, ID 83835-8790
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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