Individual
ANDREA LEIGH BAIN-FRYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1627 HENTHORNE DR STE C, MAUMEE, OH 43537-1370
(419) 491-0420
(567) 698-7875
Mailing address
2613 E SUNRISE CT, BRANDON, SD 57005-6673
(419) 870-6113
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.1800919
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0373567
—
OH
Enumeration date
06/17/2019
Last updated
03/17/2020
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