Provider Demographics
NPI:1891515334
Name:FITZER, ADRIENNE ABBY (PHD, BCBA, LBA)
Entity type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:ABBY
Last Name:FITZER
Suffix:
Gender:F
Credentials:PHD, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 RETFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2825
Mailing Address - Country:US
Mailing Address - Phone:973-714-1782
Mailing Address - Fax:
Practice Address - Street 1:16 SOUTH AVE W # 217
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2695
Practice Address - Country:US
Practice Address - Phone:973-714-1782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1257103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst