Provider Demographics
NPI:1730107459
Name:OBERHOLTZER, DONNA (MSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:OBERHOLTZER
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 1:2111 O ST NW
Mailing Address - Street 2:ONEHALF A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1008
Mailing Address - Country:US
Mailing Address - Phone:202-277-4644
Mailing Address - Fax:
Practice Address - Street 1:50 E ST SE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2620
Practice Address - Country:US
Practice Address - Phone:202-277-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3030571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
282133OtherMHN
282133OtherMHN