Basic Information
Provider Information
NPI: 1952694226
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRITZLER
FirstName: LIBERTY
MiddleName: JENNIFER
NamePrefix: DR.
NameSuffix:  
Credential: M.D., M.B.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ELLIOTT
OtherFirstName: LIBERTY
OtherMiddleName: JENNIFER
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.B.A.
OtherLastNameType: 1
Mailing Information
Address1: 1 PERKINS SQ
Address2:  
City: AKRON
State: OH
PostalCode: 443081063
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1 PERKINS SQ
Address2:  
City: AKRON
State: OH
PostalCode: 443081063
CountryCode: US
TelephoneNumber: 3305438589
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2011
LastUpdateDate: 04/29/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X126743OHY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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