Individual
JASON R FRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSL/MS
Contact information
Practice address
62 PLAZA LN, WELLSBORO, PA 16901-1766
(570) 724-7142
Mailing address
1 W MAIN ST, FLEETWOOD, PA 19522-1350
(610) 944-0445
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
101YP2500X
PA
Other
Enumeration date
12/02/2018
Last updated
12/02/2018
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