Provider Demographics
NPI:1053367888
Name:MARTZ, DENISE M (PHD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:M
Last Name:MARTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:102 MEADOW LARK WAY
Mailing Address - Street 2:HOMESTEAD
Mailing Address - City:VILAS
Mailing Address - State:NC
Mailing Address - Zip Code:28692-8801
Mailing Address - Country:US
Mailing Address - Phone:828-297-4605
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PSYCHOLOGY
Practice Address - Street 2:APPALACHIAN STATE UNIVERSITY- SMITH WRIGHT HALL
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28608-0001
Practice Address - Country:US
Practice Address - Phone:828-262-2715
Practice Address - Fax:828-262-2974
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2381103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0406LOtherBCBS
NC6000414Medicaid
NC0406LOtherBCBS