Individual
NICOLE WAGUESPACK FRAZIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
37380 MILL PARK AVE, GONZALES, LA 70737-6277
(225) 571-2177
Mailing address
37380 MILL PARK AVE, GONZALES, LA 70737-6277
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z11631
LA
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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