Basic Information
Provider Information
NPI: 1023397015
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRYE
FirstName: REBECCA
MiddleName: ANE
NamePrefix: MS.
NameSuffix:  
Credential: O.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 881 SHULLO DR
Address2:  
City: AKRON
State: OH
PostalCode: 443135852
CountryCode: US
TelephoneNumber: 3308361458
FaxNumber: 3308679570
Practice Location
Address1: 1 PARK WEST BLVD
Address2: SUITE 270
City: AKRON
State: OH
PostalCode: 443204218
CountryCode: US
TelephoneNumber: 3305644100
FaxNumber: 3305644106
Other Information
ProviderEnumerationDate: 08/09/2011
LastUpdateDate: 08/09/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X870OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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