Provider Demographics
NPI:1386309235
Name:FRYAR, TORI MICHELLE
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:MICHELLE
Last Name:FRYAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 MEYER WAY APT 7393
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1513
Mailing Address - Country:US
Mailing Address - Phone:903-328-8588
Mailing Address - Fax:
Practice Address - Street 1:6501 MEYER WAY APT 7393
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1513
Practice Address - Country:US
Practice Address - Phone:903-328-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117055235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist