Provider Demographics
NPI:1629473756
Name:BARNEY FRITSCH, CAITLIN
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:
Last Name:BARNEY FRITSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11260 BOWEN RD
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:OH
Mailing Address - Zip Code:44255-9454
Mailing Address - Country:US
Mailing Address - Phone:330-357-8203
Mailing Address - Fax:
Practice Address - Street 1:11260 BOWEN RD
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:OH
Practice Address - Zip Code:44255-9454
Practice Address - Country:US
Practice Address - Phone:330-357-8203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1629473756Medicaid