Provider Demographics
NPI:1548145139
Name:FRITZ, KATIE (EDS)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18330 PURPLE MARTIN PKWY
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-4085
Mailing Address - Country:US
Mailing Address - Phone:402-289-5787
Mailing Address - Fax:
Practice Address - Street 1:18330 PURPLE MARTIN PKWY
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-4085
Practice Address - Country:US
Practice Address - Phone:402-289-5787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool