Provider Demographics
NPI:1033172697
Name:FRITZ, RUTH LESLIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:LESLIE
Last Name:FRITZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2716
Mailing Address - Country:US
Mailing Address - Phone:978-465-2603
Mailing Address - Fax:
Practice Address - Street 1:23 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2716
Practice Address - Country:US
Practice Address - Phone:978-465-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6173103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical