Individual
BRITTANY FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1277 SHAWNEE RD, BOURBONNAIS, IL 60914-1364
(937) 631-2553
Mailing address
1277 SHAWNEE RD, BOURBONNAIS, IL 60914-1364
(937) 631-2553
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053724195
BEHAVIORAL HEALTH
—
Enumeration date
02/25/2019
Last updated
02/25/2019
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