Provider Demographics
NPI:1629191390
Name:FRETZ, RALPH JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:JOSEPH
Last Name:FRETZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 HIGHWAY 35
Mailing Address - Street 2:BUILDING G, SUITE 103
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1918
Mailing Address - Country:US
Mailing Address - Phone:973-390-2151
Mailing Address - Fax:732-528-0040
Practice Address - Street 1:2517 HIGHWAY 35
Practice Address - Street 2:BUILDING G, SUITE 103
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1918
Practice Address - Country:US
Practice Address - Phone:973-390-2151
Practice Address - Fax:732-528-0040
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3846103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic