Healthcare Provider Details

I. General information

NPI: 1265641625
Provider Name (Legal Business Name): ANTHONY CHRISTOPHER FRYER MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3414 EDWARDS RD
CINCINNATI OH
45208-2106
US

IV. Provider business mailing address

6879 STONINGTON RD
CINCINNATI OH
45230-3866
US

V. Phone/Fax

Practice location:
  • Phone: 513-631-4769
  • Fax:
Mailing address:
  • Phone: 513-232-5264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberF0042
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: