Individual
MR. LYLE R FRIED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAP, ICADC
Contact information
Practice address
5785 NW WESLEY RD, PORT SAINT LUCIE, FL 34986-4207
(772) 332-8711
Mailing address
5785 NW WESLEY RD, PORT SAINT LUCIE, FL 34986-4207
(772) 332-8711
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4805
FL
Other
Enumeration date
01/31/2022
Last updated
03/12/2022
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