Healthcare Provider Details

I. General information

NPI: 1619513694
Provider Name (Legal Business Name): MARY ANN FRITSCHIE HWC, RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 02/23/2020
Certification Date: 02/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 S COLORADO BLVD
DENVER CO
80222-5910
US

IV. Provider business mailing address

1129 29TH ST APT 201
DENVER CO
80205-2265
US

V. Phone/Fax

Practice location:
  • Phone: 720-524-2700
  • Fax:
Mailing address:
  • Phone: 720-551-6334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: