Provider Demographics
NPI:1093074924
Name:FRYE, MAGGIE LOUISE (MED CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:LOUISE
Last Name:FRYE
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 COLSTON PL
Mailing Address - Street 2:APT. 303
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6618
Mailing Address - Country:US
Mailing Address - Phone:540-842-2009
Mailing Address - Fax:
Practice Address - Street 1:521 COLSTON PL
Practice Address - Street 2:APT. 303
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6618
Practice Address - Country:US
Practice Address - Phone:540-842-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-13
Last Update Date:2012-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006240235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist