Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | PA |
NPI | 1003387036 |
---|---|
Provider Name | Schante Yolanda Frazier |
First Address | Philadelphia, PA 19132-1312 |
Second Address | Philadelphia, PA 19132-1312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2018 |
Last Update Date | 17/12/2018 |