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General NPI Number Information
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NPI Number | 1518526383
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Entity Type | Organization
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Legal Business Name | JOAN M FRYE, PHD
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 1134 DOW ST
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City | MURFREESBORO
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State | TN
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Zip | 37130-2486
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Country | US
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Telephone | 615-624-4494
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Fax | 615-823-2879
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Provider Business Mailing Address
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Address Line | 1134 DOW ST
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City | MURFREESBORO
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State | TN
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Zip | 37130-2486
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Country | US
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Telephone | 615-624-4494
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Fax | 615-823-2879
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | JOAN M FRYE
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Credential | PHD
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Telephone | 615-624-4494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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