Individual
IDA BELL ANTIONETTE FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FAMILY CARE PROVIDER
Contact information
Practice address
7777 US RTE 66, EL RENO, OK 73036
(405) 424-7711
Mailing address
7777 US RTE 66, EL RENO, OK 73036
(405) 802-3653
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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