| Doctor Name: | DR. TEDDY RAY FRAKER |
| NPI Number: | 1033143219 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW-C, PH.D |
| License Number: | 00307 |
| Business Practice Address: | 135 N Parke St Aberdeen, MD - 210012428 |
| Business Phone Number: | 4436251600 |
| Business Fax Number: | |
| Mailing Address: | 112 Edith Stone Dr, ABINGDON |
| State: | MD |
| Postal Code: | 210091170 |
| Phone Number: | 4105698224 |
| Fax Number: | 4436251520 |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 00307 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |