Organization
ROGER K FRETZ P H D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER KEITH FRETZ PH.D (PRESIDENT)
(717) 627-4624
Entity
Organization
Contact information
Practice address
57 E MAIN ST, LITITZ, PA 17543-1941
(717) 627-4624
(717) 627-4624
Mailing address
57 E MAIN ST, LITITZ, PA 17543-1941
(717) 627-4624
(717) 627-4624
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS003768L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS003768L
LICENSE
PA
Enumeration date
05/25/2007
Last updated
09/21/2011
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