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NPI 1124818778

NPI 1124818778 : DELIAH FRY : BURLINGTON, NC

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General NPI Number Information
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    NPI Number           |    1124818778
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    Entity Type          |    Individual 
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    Provider Name        |    DELIAH FRY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/07/2025
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    Last Update Date     |    05/07/2025
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Provider Practice Location Address
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    Address Line         |    1205 S MAIN ST 
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    City                 |    BURLINGTON
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    State                |    NC
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    Zip                  |    27215-5762
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    Country              |    US
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    Telephone            |    336-684-9951
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4702 WAKEWOOD DR 
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    City                 |    GREENSBORO
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    State                |    NC
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    Zip                  |    27407-4063
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    P021292
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    License Number State |    NC
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