Provider Demographics
NPI:1124911805
Name:FRAZIER, GLORIA MEA (GLORIA FRAZIER, RBT)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:MEA
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:GLORIA FRAZIER, RBT
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:MEA
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:GLORIA FRAZIER, RBT
Mailing Address - Street 1:365 SOSBY CIR
Mailing Address - Street 2:
Mailing Address - City:CARNESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30521-2424
Mailing Address - Country:US
Mailing Address - Phone:678-520-1942
Mailing Address - Fax:
Practice Address - Street 1:447 BRADFORD ST NW
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3210
Practice Address - Country:US
Practice Address - Phone:706-870-1331
Practice Address - Fax:678-765-6971
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GABACB1026457106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician