Provider Demographics
NPI:1376648006
Name:FRYE, KRISTI REBEKAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:REBEKAH
Last Name:FRYE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5646 MILTON ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3907
Mailing Address - Country:US
Mailing Address - Phone:214-616-8185
Mailing Address - Fax:972-668-1537
Practice Address - Street 1:5646 MILTON ST
Practice Address - Street 2:SUITE 340
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-3907
Practice Address - Country:US
Practice Address - Phone:214-616-8185
Practice Address - Fax:972-668-1537
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15042101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health