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General NPI Number Information
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NPI Number | 1700608049
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Entity Type | Individual
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Provider Name | EMILY ANN FRITZ
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3859 FEE FEE RD
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City | BRIDGETON
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State | MO
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Zip | 63044-2937
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Country | US
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Telephone | 314-410-9670
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 S 11TH ST APT B
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City | SAINT LOUIS
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State | MO
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Zip | 63104-3915
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Country | US
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Telephone | 314-223-5761
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 2024043182
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License Number State | MO
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