Provider Demographics
NPI:1871669945
Name:FRY, RACHEL B (PH,D,)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:B
Last Name:FRY
Suffix:
Gender:F
Credentials:PH,D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 INDEPENDENCE DR STE 307
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4165
Mailing Address - Country:US
Mailing Address - Phone:205-803-3800
Mailing Address - Fax:205-803-3803
Practice Address - Street 1:3125 INDEPENDENCE DR STE 307
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4165
Practice Address - Country:US
Practice Address - Phone:205-803-3800
Practice Address - Fax:205-803-3803
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1383103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical