Fryar, Jill Brown

Fryar, Jill Brown is an individual health care provider with primary practice located at 6621 Fannin St Ccc 1630.00, Houston TX 77030-2303. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Fryar, Jill Brown can be contacted via phone (832) 822-3700.

Contact Information

Primary practice address
6621 Fannin St Ccc 1630.00 Houston TX 77030-2303
Fax: (832) 825-4164
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X S11574 Texas
Behavioral Health & Social Service Providers / Clinical 1041C0700X S11574 Texas

Profile Details

NPI number 1801940416
LBN Legal business name Fryar, Jill Brown
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Nov 11th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801940416 NPPES
Texas MEDICAID 1009011-02

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