Individual
MIRANDA LEE FRAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FSP
Contact information
Practice address
512 E 24TH ST, TISHOMINGO, OK 73460
(580) 622-2783
Mailing address
1488 JENICE DR, SULPHUR, OK 73086-1121
(580) 247-0169
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/30/2011
Last updated
03/29/2019
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