MEDICARE: KATLYN ELIZABETH FRY MS, CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	14033	NC

General Provider Information

NPI Number	:	1750905477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATLYN ELIZABETH FRY MS, CCC-SLP

Provider Business Mailing Address
First Line	:	403 ONEIL DR
Second Line	:
City	:	JAMESTOWN
State	:	NC
Zip	:	27282-9796
Country	:	US
Telephone Number	:	704-578-4128
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 ADAMS FARM LN UNIT F
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-7098
Country	:	US
Telephone Number	:	704-578-4128
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2020
Last Update Date	:	11/13/2025

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