Provider Demographics
NPI:1558930438
Name:BARTZ, DEBRA ANN (HEALTH COACH)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:BARTZ
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8646 WAGNER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TALENT
Mailing Address - State:OR
Mailing Address - Zip Code:97540-7792
Mailing Address - Country:US
Mailing Address - Phone:925-207-9533
Mailing Address - Fax:
Practice Address - Street 1:8646 WAGNER CREEK RD
Practice Address - Street 2:
Practice Address - City:TALENT
Practice Address - State:OR
Practice Address - Zip Code:97540-7792
Practice Address - Country:US
Practice Address - Phone:925-207-9533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR171400000XOtherHEALTH COACHING