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NPI Code Detail

MEDICARE: PRINCESSBRITTNI NICOLE FRYER

MEDICARE: PRINCESSBRITTNI NICOLE FRYER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1366397416
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRINCESSBRITTNI NICOLE FRYER
Provider Business Mailing Address
First Line : 1526 E DIVISION ST
Second Line :
City : DECATUR
State : IL
Zip : 62526-5027
Country : US
Telephone Number : 217-480-4655
Fax Number :
Provider Business Practice Location Address
First Line : 2535 MILLIKIN PKWY
Second Line :
City : DECATUR
State : IL
Zip : 62526-2156
Country : US
Telephone Number : 888-515-1793
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “ PRINCESSBRITTNI NICOLE FRYER ” Practice Location

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