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General NPI Number Information
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NPI Number | 1851117865
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Entity Type | Individual
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Provider Name | HEATHER FRITCH PH.D
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Gender | Female
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 123 N MAIN ST
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City | CROWN POINT
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State | IN
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Zip | 46307-4077
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Country | US
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Telephone | 708-207-8509
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Fax |
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Provider Business Mailing Address
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Address Line | 9731 NORTHCOTE AVE STE B
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City | SAINT JOHN
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State | IN
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Zip | 46373-9532
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Country | US
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Telephone | 708-207-8509
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0704010761
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License Number State | VA
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