Healthcare Provider Details

I. General information

NPI: 1386741197
Provider Name (Legal Business Name): THOMAS FREDERICK FRYE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 WHITE MOUNTAIN HIGHWAY
TAMWORTH NH
03851
US

IV. Provider business mailing address

448 WHITE MOUNTAIN HIGHWAY
TAMWORTH NH
03851
US

V. Phone/Fax

Practice location:
  • Phone: 603-323-7434
  • Fax: 603-323-7426
Mailing address:
  • Phone: 603-323-7434
  • Fax: 603-323-7426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number534
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: