Provider Demographics
NPI:1053552448
Name:FRAZIER, ADRYNNE (PSYD)
Entity type:Individual
Prefix:
First Name:ADRYNNE
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ADRYNNE
Other - Middle Name:
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD LLC
Mailing Address - Street 1:11050 MILL RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-5001
Mailing Address - Country:US
Mailing Address - Phone:804-516-0650
Mailing Address - Fax:
Practice Address - Street 1:11050 MILL RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-5001
Practice Address - Country:US
Practice Address - Phone:804-516-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006327103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical