Individual
LOIS FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 SEAVIEW AVE, JERSEY CITY, NJ 07305-2411
(201) 434-4240
Mailing address
504 W SIDE AVE, PO BOX 24145, JERSEY CITY, NJ 07304-1528
(201) 988-4329
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
16-14012
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033168
—
NJ
Enumeration date
03/22/2017
Last updated
03/22/2017
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