Individual
CAROL SULLIVAN FRAISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
819 CENTRAL AVE, BAY ST LOUIS, MS 39520-3913
(228) 467-1881
Mailing address
515 CARROLL AVE, BAY ST LOUIS, MS 39520-3515
(601) 214-1308
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M9097
MS
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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