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Individual

MIKAELA TEEL FRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14 WHITTIER AVE, MOORESTOWN, NJ 08057-1531
(609) 321-4966
Mailing address
14 WHITTIER AVE, MOORESTOWN, NJ 08057-1531
(609) 321-4966

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
44SL07237900
NJ

Other

Enumeration date
01/14/2025
Last updated
01/14/2025
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