Provider Demographics
NPI:1285305730
Name:FRITZ, REBECCA (RBT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 COMMERCE WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-3244
Mailing Address - Country:US
Mailing Address - Phone:603-433-4192
Mailing Address - Fax:
Practice Address - Street 1:215 COMMERCE WAY STE 300
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3244
Practice Address - Country:US
Practice Address - Phone:603-433-4192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHRBT-20-131876106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician