Provider Demographics
NPI:1295002897
Name:FRYSH, DANIEL JOEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOEL
Last Name:FRYSH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 IRIS AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2226
Mailing Address - Country:US
Mailing Address - Phone:678-778-4063
Mailing Address - Fax:
Practice Address - Street 1:1333 IRIS AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2226
Practice Address - Country:US
Practice Address - Phone:678-778-4063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-27
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor