Provider Demographics
NPI:1164761045
Name:HOLTZMAN, NATALIE SONSHINE (MSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:SONSHINE
Last Name:HOLTZMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5456
Mailing Address - Country:US
Mailing Address - Phone:772-335-0166
Mailing Address - Fax:772-335-0169
Practice Address - Street 1:1541 SE PORT ST LUCIE BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5456
Practice Address - Country:US
Practice Address - Phone:772-335-0166
Practice Address - Fax:772-335-0169
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker