Provider Demographics
NPI:1366781692
Name:FRITZ, ANN M
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:FRITZ
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 1:10534 W EDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4653
Mailing Address - Country:US
Mailing Address - Phone:989-906-2611
Mailing Address - Fax:
Practice Address - Street 1:4525 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6905
Practice Address - Country:US
Practice Address - Phone:602-373-3136
Practice Address - Fax:866-422-2651
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2019-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1366781692Medicaid