Provider Demographics
NPI:1124468616
Name:FRITZ, SAMANTHA JEAN (BA MS)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:JEAN
Last Name:FRITZ
Suffix:
Gender:F
Credentials:BA MS
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:JEAN
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA MS
Mailing Address - Street 1:6809 N CHARLESWORTH ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1912
Mailing Address - Country:US
Mailing Address - Phone:313-806-0474
Mailing Address - Fax:
Practice Address - Street 1:6809 N CHARLESWORTH ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1912
Practice Address - Country:US
Practice Address - Phone:313-806-0474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker