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Individual

JENNA FRYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 803-1617
Mailing address
1160 KEPLER DR, GREEN BAY, WI 54311-8321

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
225X00000X
Occupational Therapist
Primary
17326-24
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100284043
WI
Enumeration date
08/30/2021
Last updated
10/21/2025
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