Provider Demographics
NPI:1447885314
Name:FRITZ, CHARLOTTE LANGFORD (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:LANGFORD
Last Name:FRITZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:ELIZABETH
Other - Last Name:LANGFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4173 NEWGARD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-2446
Mailing Address - Country:US
Mailing Address - Phone:248-520-1214
Mailing Address - Fax:
Practice Address - Street 1:2000 E OAKLEY PARK RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-1500
Practice Address - Country:US
Practice Address - Phone:248-387-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101008314235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist