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General NPI Number Information
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NPI Number | 1114787140
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Entity Type | Individual
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Provider Name | LORETTA L MARTZAHL LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/19/2024
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 1850 SW PLAZA SHOPS LN
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City | ANKENY
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State | IA
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Zip | 50023-7167
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Country | US
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Telephone | 515-508-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 530 E 2ND ST
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City | HUXLEY
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State | IA
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Zip | 50124-8117
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Country | US
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Telephone | 515-209-1336
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 116959
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License Number State | IA
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