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
| Name | Value | ||||||||
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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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