Individual
MRS. KATHLEEN M. FRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
602 CARDINAL LN, TYNGSBORO, MA 01879-1583
(978) 815-4800
Mailing address
929 E 11190 S, SANDY, UT 84094-5329
(978) 815-4800
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810007470
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/06/2011
Last updated
06/28/2021
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