Provider Information for 1891701850
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Mr. JEFFREY SCOT FRY LCSW
Sex: Male
NPI: 1891701850
Last Updated: 2011-02-02
Certification Date:
Certification Date:
Details
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NPI | 1891701850 | ||||||||
Enumeration Date | 2006-07-31 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 3593 BROOKEFALL CT SUWANEE, GA 30024-7033 United States Phone: 866-525-2128 | Fax:866-514-9557 | ||||||||
Primary Practice Address | 370 PROSPECT PL ALPHARETTA, GA 30005-5467 United States Phone: 866-525-2128 | Fax:866-514-9557 | ||||||||
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