Provider Demographics
NPI:1821893264
Name:FRITZ, ELIANA LOLITA
Entity type:Individual
Prefix:MISS
First Name:ELIANA
Middle Name:LOLITA
Last Name:FRITZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13216 WESTHAMPTON PL APT 303
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-8699
Mailing Address - Country:US
Mailing Address - Phone:317-601-4892
Mailing Address - Fax:
Practice Address - Street 1:5365 DOLLAR FORGE CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46221-4692
Practice Address - Country:US
Practice Address - Phone:317-601-4892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician