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1699339051
DALE ANTHONY FRASER
JAMAICA, NY
NPI
1699339051
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-04-30
Last Update Date
2019-04-30
Business Address
DALE ANTHONY FRASER
16318 JAMAICA AVE
JAMAICA, NY 11432-4919
Phone number: 718-658-0010
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Mailing Address
DALE ANTHONY FRASER
16318 JAMAICA AVE
JAMAICA, NY 11432-4919
Phone number:
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