Individual
NICOLE DIANA FRAZIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 2ND ST, ANNAPOLIS, MD 21401-6951
(443) 221-8769
Mailing address
2700 SOUTH HAVEN ROAD, ANNAPOLIS, MD 21401
(410) 897-1300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02333
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750402343
SAVA
MD
Enumeration date
02/21/2019
Last updated
02/21/2019
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