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NPI Code Detail

MEDICARE: MS. MARCIE MARIE PLATTE LISW

MEDICARE: MS. MARCIE MARIE PLATTE LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.0009883OH

General Provider Information

NPI Number : 1720298151
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARCIE MARIE PLATTE LISW
Provider Business Mailing Address
First Line : 1217 COLUMBUS AVE
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-3520
Country : US
Telephone Number : 419-627-8747
Fax Number :
Provider Business Practice Location Address
First Line : 1218 CLEVELAND RD
Second Line : SUITE B
City : SANDUSKY
State : OH
Zip : 44870-4200
Country : US
Telephone Number : 419-626-9156
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 07/08/2007

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