Provider Demographics
NPI:1700107570
Name:FRYE, DANIEL CARL (LMFT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:CARL
Last Name:FRYE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 887
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-0887
Mailing Address - Country:US
Mailing Address - Phone:715-384-7589
Mailing Address - Fax:715-384-8131
Practice Address - Street 1:252 S CENTRAL AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-2843
Practice Address - Country:US
Practice Address - Phone:715-384-7589
Practice Address - Fax:715-384-8131
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI830-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist