Individual
MR. KEVIN MATTHEW FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
208 CONFERENCE CENTER BUILDING 600 HENLEY STREET, KNOXVILLE, TN 37996-0001
(865) 974-2161
Mailing address
1520 GREENBRIER RIDGE WAY APT 1215, KNOXVILLE, TN 37909-3380
(610) 914-7371
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134128820
PROVIDER N.P.I.
TN
05
—
3686393
—
TN
Enumeration date
05/04/2020
Last updated
05/04/2020
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