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Individual

ANGELA JOY FRAZER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1002 WISHARD BLVD, INDIANAPOLIS, IN 46202-4163
(317) 944-8868
(317) 944-6680
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004110A
IN
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
183380124
MEDICARE
IN
05
200544620
IN
Enumeration date
08/20/2021
Last updated
12/13/2022
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