Provider Demographics
NPI:1245854124
Name:LINZ, MARIANNA (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIANNA
Middle Name:
Last Name:LINZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARIANNA
Other - Middle Name:
Other - Last Name:FOOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2643 LOWER CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541
Mailing Address - Country:US
Mailing Address - Phone:304-412-4237
Mailing Address - Fax:
Practice Address - Street 1:1 JOHN MARSHALL DR DEPT OF
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25755-0003
Practice Address - Country:US
Practice Address - Phone:304-696-2774
Practice Address - Fax:304-696-2784
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV582103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist