Provider Demographics
NPI:1497246367
Name:FRITZ, ANDREA M (MSOT, OTRL)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:M
Last Name:FRITZ
Suffix:
Gender:F
Credentials:MSOT, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1558 BRIARSON DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-4461
Mailing Address - Country:US
Mailing Address - Phone:989-928-1564
Mailing Address - Fax:
Practice Address - Street 1:2950 LAFRANIER RD
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-4918
Practice Address - Country:US
Practice Address - Phone:231-947-0506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201010210225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist