Healthcare Provider Details

I. General information

NPI: 1356618409
Provider Name (Legal Business Name): MICHELE MARIE FRY MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1681 CROWN AVE STE 103
LANCASTER PA
17601-6303
US

IV. Provider business mailing address

1681 CROWN AVE STE 103
LANCASTER PA
17601-6303
US

V. Phone/Fax

Practice location:
  • Phone: 717-219-8867
  • Fax:
Mailing address:
  • Phone: 717-219-8867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: