Provider Demographics
NPI:1306925995
Name:ZEITHAMMEL, MANFRIED KARL (DIPLOMATE, SOC WRK)
Entity type:Individual
Prefix:MR
First Name:MANFRIED
Middle Name:KARL
Last Name:ZEITHAMMEL
Suffix:
Gender:M
Credentials:DIPLOMATE, SOC WRK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 EAGLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-9206
Mailing Address - Country:US
Mailing Address - Phone:830-393-0293
Mailing Address - Fax:210-652-5321
Practice Address - Street 1:555 F ST W
Practice Address - Street 2:
Practice Address - City:RANDOLPH A F B
Practice Address - State:TX
Practice Address - Zip Code:78150-4536
Practice Address - Country:US
Practice Address - Phone:210-652-5321
Practice Address - Fax:210-652-3166
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0343501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical