=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043516420
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARYN M FRYE M.S., CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2011
-----------------------------------------------------
Last Update Date | 02/02/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 227 SAND HILL RD
-----------------------------------------------------
City | GREENSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15601-6475
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-537-7360
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 117 MANOR VIEW DR
-----------------------------------------------------
City | MANOR
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15665-9735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-864-0940
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SL008482
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------