| Doctor Name: | MARY J LANDKAMER-TAGATZ |
| NPI Number: | 1083881924 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 1634 - 123 |
| Business Practice Address: | 161 Spring St Westfield, WI - 539649068 |
| Business Phone Number: | 6082962139 |
| Business Fax Number: | |
| Mailing Address: | 161 Spring St, WESTFIELD |
| State: | WI |
| Postal Code: | 539649068 |
| Phone Number: | 6082962139 |
| Fax Number: | |
| NPI Enumeration Date: | 05/09/2008 |
| NPI Last Update Date: | 05/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1634 - 123 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |