Provider Demographics
NPI:1568754117
Name:FRITH, RODERICK MURRAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:MURRAY
Last Name:FRITH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:MR
Other - First Name:RODERICK
Other - Middle Name:MURRAY
Other - Last Name:FRITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1051 WHARF ST # 4524
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-0403
Mailing Address - Country:US
Mailing Address - Phone:626-533-0686
Mailing Address - Fax:
Practice Address - Street 1:1051 WHARF ST
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-0403
Practice Address - Country:US
Practice Address - Phone:626-533-0686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114489106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist