| Name: | Fry Behavioral Health, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 28 Feb 2011 (14 years ago) (Companies founded in February 2011) |
| Date of dissolution: | 02 Nov 2023 |
| Entity Number: | 000-004-730 |
| Register Number: | 000004730 |
| ZIP code: | 35222 (Companies in Jefferson, 35222) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 4154 CLIFF ROAD SOUTHBIRMINGHAM, AL 35222 |
| Authorized Capital: | 1,000 @ $.01 PV |
Activities
PROFESSIONAL PSYCHOLOGICAL THERAPY FOR ADOLESCENTS/RELATED SERVI
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942593579 | 2011-05-16 | 2011-08-03 | 3125 INDEPENDENCE DR, SUITE 307, BIRMINGHAM, AL, 352094159, US | 3125 INDEPENDENCE DR, SUITE 307, BIRMINGHAM, AL, 352094159, US | |||||||||||||||||||||||||
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| Phone | +1 205-803-3800 |
| Fax | 2058033803 |
Authorized person
| Name | DR. RACHEL B FRY |
| Role | PSYCHOLOGIST |
| Phone | 2058033800 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | 1383 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI 1871669945 |
| Number | 1871669945 |
| State | AL |
| Name | Role |
|---|---|
| FRY, RACHEL B | Agent |
| Name | Role | Address |
|---|---|---|
| FRY, RACHEL BLAKE | Director | 4154 CLIFF ROAD SOUTHBIRMINGHAM, AL 35222 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
