Individual
LOWELL LAWRENCE FRY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, MA
Contact information
Practice address
1032 CROSSWINDS CT, WENTZVILLE, MO 63385-4836
(636) 445-7161
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(844) 853-8937
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161949
OH
101YP2500X
Professional Counselor
Primary
2020021862
MO
101YP2500X
Professional Counselor
E.1800740-SUPV
OH
Other
Enumeration date
09/13/2017
Last updated
05/28/2024
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