Provider Demographics
NPI:1215099080
Name:HOLTZMAN, MARGARET MARY (LMSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:HOLTZMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4910
Mailing Address - Country:US
Mailing Address - Phone:734-572-0882
Mailing Address - Fax:
Practice Address - Street 1:118 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4910
Practice Address - Country:US
Practice Address - Phone:734-572-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010642791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008976350OtherBLUE CROSS PIN
MIP00800002Medicare ID - Type UnspecifiedMEMBER NUMBER