National Provider Identifier
Jacob David Bourne-Frazer
Jacob David Bourne-Frazer is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Rochester, NY and a listed phone number of (585) 368-6700.
Profile Overview
- NPI
- 1083337109
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- September 23, 2022
- Last Updated
- July 25, 2023
Practice Location
- 100 Pinewild Dr Ste 2A
- Rochester, NY 14606-4200
Phone: (585) 368-6700
Specialties
- Mental Health Counselor (101YM0800X)
Full Record
- NPI
- 1083337109
- Entity Type
- Individual
- Last Name
- Bourne-Frazer
- First Name
- Jacob
- Middle Name
- David
- Mailing Street Address
- 100 Pinewild Dr Ste 2A
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14606-4200
- Mailing Country
- US
- Mailing Phone
- (585) 368-6700
- Mailing Fax
- (585) 368-6767
- Practice Street Address
- 100 Pinewild Dr Ste 2A
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14606-4200
- Practice Country
- US
- Practice Phone
- (585) 368-6700
- Practice Fax
- (585) 368-6767
- Enumeration Date
- September 23, 2022
- Last Updated
- July 25, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- July 25, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X)