Princess K Frazier-Lyles
Individual provider Active NPI Behavior Technician · Montgomery Village, MD
NPI 1972236545 · NPPES record last updated Jul 1, 2022
Key facts
- NPI
- 1972236545
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 10051 Maple Leaf Dr
Montgomery Village, MD 20886-1131 - Phone
- (301) 664-0920
- NPI assigned
- Jul 1, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | MD | Yes |
Addresses
Primary practice location
10051 Maple Leaf Dr
Montgomery Village, MD 20886-1131
Mailing address
10051 Maple Leaf Dr
Montgomery Village, MD 20886-1131
Phone (301) 664-0920
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40302261000 | Medicaid | MD |
Other providers in Montgomery Village, MD
- Richard Ewusie-Monney
- Shamaria A Fahie
- Cristobal R. Fernandez
- Edward Joseph Feroli
- Liliane Fobasso
- G. Ghamary DDS #1 PC
- Grace Emilya Garcia
- Andrea Simone Gardner
- Allyson Garrett
- Ghafoor Ghamary
All providers in Montgomery Village, MD · Behavior Technician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.