Provider Demographics
NPI:1467925685
Name:FOLTZ, MARTHA TANSEY
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:TANSEY
Last Name:FOLTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18505 TONTOGANY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9037
Mailing Address - Country:US
Mailing Address - Phone:419-823-4381
Mailing Address - Fax:
Practice Address - Street 1:18505 TONTOGANY CREEK RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-9037
Practice Address - Country:US
Practice Address - Phone:419-823-4381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.1061235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty