Individual
MARTHA J FRAZIER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1216 DEADRA DR, LEBANON, MO 65536-4669
(417) 532-7102
(417) 532-6606
Mailing address
123 NORTHGATE DR, LEBANON, MO 65536-3861
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
000047
MO
Other
Enumeration date
12/16/2005
Last updated
07/08/2007
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