Provider Information for 1427462852
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CHARLES A FRAZIER LCSW, MBA
Sex: Male
NPI: 1427462852
Last Updated: 2014-06-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1427462852 | ||||||||
| Enumeration Date | 2014-06-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 154 HARTFORD, CT 06141-0154 United States Phone: 860-817-8640 | Fax:860-736-2222 | ||||||||
| Primary Practice Address | 880 ASYLUM AVE HARTFORD, CT 06105-1902 United States Phone: 860-817-8640 | Fax:860-736-2222 | ||||||||
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