Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor |
NPI | 1003583691 |
---|---|
Provider Name | Danielle Marie Fry |
First Address | Chicora, PA 16025-3907 |
Second Address | Butler, PA 16001-5994 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2021 |
Last Update Date | 23/08/2021 |