Provider Demographics
NPI:1619513694
Name:FRITSCHIE, MARY ANN (HWC, RBT)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:FRITSCHIE
Suffix:
Gender:F
Credentials:HWC, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 29TH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2265
Mailing Address - Country:US
Mailing Address - Phone:720-551-6334
Mailing Address - Fax:
Practice Address - Street 1:2625 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5910
Practice Address - Country:US
Practice Address - Phone:720-524-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician