Individual
MARLA D MINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39001064A
IN
1041C0700X
Clinical Social Worker
Primary
34003950A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000752449
ANTHEM
IN
01
—
11609129
CAQH
IN
Enumeration date
08/12/2006
Last updated
07/01/2013
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