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Individual

MR. THOMAS GASTON FRYE IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC II

Contact information

Practice address
1651 CENTENNIAL BLVD, SPRINGFIELD, OR 97477-3363
(541) 762-4532
(541) 726-2467
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 762-4532
(541) 726-2467

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16-R-09
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16-R-09
ADDICITION COUNSELING BOARD OF OREGON
OR
01
5863
CERTIFIED RECIPROCAL ALCOHOL AND DRUG COUNSELOR
MO
Enumeration date
11/03/2015
Last updated
07/21/2022
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