Provider Demographics
NPI:1154743896
Name:FRAZER, DEBORAH EDELMAN (MS, BCBA, LABA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:EDELMAN
Last Name:FRAZER
Suffix:
Gender:F
Credentials:MS, BCBA, LABA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:FRAZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:98 HOVEY ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3356
Mailing Address - Country:US
Mailing Address - Phone:609-742-5049
Mailing Address - Fax:
Practice Address - Street 1:345A GREENWOOD STREET
Practice Address - Street 2:SUITE B
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01607-1767
Practice Address - Country:US
Practice Address - Phone:508-363-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst