Individual
MRS. JESSICA RAE FRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5570 DERRY ST, HARRISBURG, PA 17111-3517
(717) 525-9804
Mailing address
440A GRANT ST, MIDDLETOWN, PA 17057-1178
(570) 241-7221
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC010966
PA
101YP2500X
Professional Counselor
PC010966
PA
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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