Individual
MRS. DIANNE MARTAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
405 EAST MAIN STREET, MARSHALL, AR 72650
(870) 448-2176
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1433C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5Y525
MEDICARE ID
—
Enumeration date
08/01/2006
Last updated
04/20/2020
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