Provider Demographics
NPI:1518123728
Name:FRY, RACHEL (RACHEL FRY)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:FRY
Suffix:
Gender:F
Credentials:RACHEL FRY
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:KIBLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1586 EGGERT RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3361
Mailing Address - Country:US
Mailing Address - Phone:716-400-4569
Mailing Address - Fax:
Practice Address - Street 1:1586 EGGERT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3361
Practice Address - Country:US
Practice Address - Phone:716-400-4569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018142-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist