Provider Demographics
NPI:1831632025
Name:DONALD R. FROYD, JR., PH.D.
Entity type:Organization
Organization Name:DONALD R. FROYD, JR., PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:FROYD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-308-9127
Mailing Address - Street 1:5601 THE GREENS CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-5098
Mailing Address - Country:US
Mailing Address - Phone:559-308-9127
Mailing Address - Fax:
Practice Address - Street 1:101 S LOCKE AVE
Practice Address - Street 2:STE 202C
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5912
Practice Address - Country:US
Practice Address - Phone:559-308-9127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0178361106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1336473305OtherNPI