Doctor Name: | MRS. MICHELLE NICOLE FRY |
NPI Number: | 1376936336 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CRC, LPC |
License Number: | 00116763 |
Business Practice Address: | 4110 Litt Dr Hillside, IL - 601621120 |
Business Phone Number: | 7085473560 |
Business Fax Number: | |
Mailing Address: | 498 Thunderbird Trl, CAROL STREAM |
State: | IL |
Postal Code: | 601881584 |
Phone Number: | 6303472925 |
Fax Number: | |
NPI Enumeration Date: | 03/13/2015 |
NPI Last Update Date: | 03/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 00116763 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |