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NPI Code Detail

MEDICARE: JOURNEA FRYE

MEDICARE: JOURNEA FRYE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst0-22-13529

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10-22-13529OTHERBEHAVIOR ANALYST CERTIFICATION BOARD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992341333
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOURNEA FRYE
Provider Business Mailing Address
First Line : 8745 PALM BREEZE RD APT 806
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-3758
Country : US
Telephone Number : 904-624-2667
Fax Number :
Provider Business Practice Location Address
First Line : 6850 103RD ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-6877
Country : US
Telephone Number : 904-201-9116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2019
Last Update Date : 05/12/2025

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Directions to “ JOURNEA FRYE ” Practice Location

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