Provider Demographics
NPI:1578957957
Name:FRAZIER, KRISTIE LAUREN (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KRISTIE
Middle Name:LAUREN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 OAK TER
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5205
Mailing Address - Country:US
Mailing Address - Phone:610-442-7898
Mailing Address - Fax:
Practice Address - Street 1:333 OAK TER
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-5205
Practice Address - Country:US
Practice Address - Phone:610-442-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist