Provider Demographics
NPI:1750306064
Name:SCHATZ, MARSHA GAIL (MS)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:GAIL
Last Name:SCHATZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4521 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6747
Mailing Address - Country:US
Mailing Address - Phone:417-882-7522
Mailing Address - Fax:
Practice Address - Street 1:4521 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-6747
Practice Address - Country:US
Practice Address - Phone:417-882-7522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional