| Doctor Name: | MARYANN LOUTZENHISER |
| NPI Number: | 1053713248 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN-247649 |
| Business Practice Address: | 4726 Main Ave Ashtabula, OH - 440046929 |
| Business Phone Number: | 4409928552 |
| Business Fax Number: | 4409926631 |
| Mailing Address: | Po Box 291, 2857 Winner Rd CLARK |
| State: | PA |
| Postal Code: | 16113 |
| Phone Number: | 7249622273 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2014 |
| NPI Last Update Date: | 09/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA0400X |
| License Number: | RN-247649 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |