Individual
MRS. JENNIFER CAROL FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
909 W MAIN ST, GREEN FOREST, AR 72638-2316
(870) 423-9246
(877) 425-4393
Mailing address
161 COUNTY ROAD 9951, GREEN FOREST, AR 72638-4022
(870) 553-2284
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
613
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119425721
—
AR
05
—
129993742
—
AR
Enumeration date
05/16/2007
Last updated
10/06/2020
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