| Doctor Name: | CARL PRINTZ |
| NPI Number: | 1952709198 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMSW |
| License Number: | LMSW-33720 |
| Business Practice Address: | 427 N 12th St Plummer, ID - 838510388 |
| Business Phone Number: | 2086861931 |
| Business Fax Number: | 2086865813 |
| Mailing Address: | 427 N 12th St, PLUMMER |
| State: | ID |
| Postal Code: | 838510388 |
| Phone Number: | 2086861931 |
| Fax Number: | 2086865813 |
| NPI Enumeration Date: | 12/19/2014 |
| NPI Last Update Date: | 12/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LMSW-33720 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |