Provider Demographics
NPI:1952816084
Name:OLTMAN, TAMMY SUE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:SUE
Last Name:OLTMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1610
Mailing Address - Country:US
Mailing Address - Phone:515-537-2975
Mailing Address - Fax:
Practice Address - Street 1:611 5TH AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1610
Practice Address - Country:US
Practice Address - Phone:515-537-2975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074456104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker