Provider Demographics
NPI:1922211879
Name:PRINTZ, MARISA LEANNE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:LEANNE
Last Name:PRINTZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 SOONER LN
Mailing Address - Street 2:
Mailing Address - City:BLANDON
Mailing Address - State:PA
Mailing Address - Zip Code:19510-9798
Mailing Address - Country:US
Mailing Address - Phone:484-797-9485
Mailing Address - Fax:
Practice Address - Street 1:402 N FULTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2002
Practice Address - Country:US
Practice Address - Phone:610-432-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1255561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical