Provider Demographics
NPI:1720891799
Name:FRITZ, SHARON (DR)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:LEASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8011 N SUNDIAL WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83714-2508
Mailing Address - Country:US
Mailing Address - Phone:208-301-2269
Mailing Address - Fax:888-977-3719
Practice Address - Street 1:8011 N SUNDIAL WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83714-2508
Practice Address - Country:US
Practice Address - Phone:208-301-2269
Practice Address - Fax:888-977-3719
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-384103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist