Individual
IVORY CHEYENNE FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 W CARROLL AVE, CHICAGO, IL 60607-1105
(088) 331-2733
Mailing address
1409 W CARROLL AVE, CHICAGO, IL 60607-1105
(088) 331-2733
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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