Provider Demographics
NPI:1902425085
Name:HARRIS-FRAZIER, DENISE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:HARRIS-FRAZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S WILCOX ST STE 206
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1957
Mailing Address - Country:US
Mailing Address - Phone:720-244-5199
Mailing Address - Fax:
Practice Address - Street 1:405 S WILCOX ST STE 206
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1957
Practice Address - Country:US
Practice Address - Phone:720-244-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4922225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty