Individual
DR. JONATHAN WILLIAM MARIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
(920) 720-3719
Mailing address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
(920) 720-3719
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3062-57
WI
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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