Provider Demographics
NPI:1629399704
Name:SPIEGELMAN, MARTHA GAIL (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:GAIL
Last Name:SPIEGELMAN
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 1:1820 RAINTREE LN
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-2043
Mailing Address - Country:US
Mailing Address - Phone:941-408-1938
Mailing Address - Fax:
Practice Address - Street 1:1820 RAINTREE LN
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-2043
Practice Address - Country:US
Practice Address - Phone:941-408-1938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-12
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 90331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical