| Doctor Name: | MS. MARCIA BERKELAND OLTROGGE |
| NPI Number: | 1194885533 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, CADC |
| License Number: | 95147 |
| Business Practice Address: | 905 Montgomery St Decorah, IA - 521012325 |
| Business Phone Number: | 5633823649 |
| Business Fax Number: | 5633828183 |
| Mailing Address: | 905 Montgomery St, P.o. Box 349 DECORAH |
| State: | IA |
| Postal Code: | 521012325 |
| Phone Number: | 5633823649 |
| Fax Number: | 5633828183 |
| NPI Enumeration Date: | 12/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 95147 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |