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General NPI Number Information
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NPI Number | 1538305016
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Entity Type | Organization
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Legal Business Name | CAROLYN D. FRYE, LLC
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 920 DANNON VW SW SUITE 3104
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City | ATLANTA
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State | GA
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Zip | 30331-2157
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Country | US
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Telephone | 404-629-3933
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Fax | 404-629-3935
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Provider Business Mailing Address
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Address Line | 920 DANNON VW SW SUITE 3104
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City | ATLANTA
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State | GA
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Zip | 30331-2157
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Country | US
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Telephone | 404-629-3933
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Fax | 404-629-3935
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | CAROLYN DELOIS FRYE
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Credential | LPN, NCC
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Telephone | 404-629-3933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC005026
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License Number State | GA
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