MEDICARE: MS. BARBARA H LANTZ LCSW

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
1	1041C0700X	Clinical Social Worker	SW5451	FL

General Provider Information

NPI Number	:	1912182403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA H LANTZ LCSW

Provider Business Mailing Address
First Line	:	5544 COGNAC DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3416
Country	:	US
Telephone Number	:	239-826-3134
Fax Number	:	239-432-9925

Provider Business Practice Location Address
First Line	:	5544 COGNAC DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3416
Country	:	US
Telephone Number	:	239-826-3134
Fax Number	:	239-432-9925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/03/2008

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