Individual
MR. KRIS EARL MARVIN
Active
Individual
MR. KRIS EARL MARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
05897
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0486761
—
IA
01
—
112848
HEALTH ALLIANCE
IA
01
—
11472253
CAQH
IA
01
—
230092
MIDLANDS CHOICE
IA
01
—
254111
COMPSYCH
IA
01
—
38640
BLUE CROSS BLUE SHIELD
IA
01
—
9385519
PRIVATE HEALTH CARE
IA
Enumeration date
09/12/2005
Last updated
06/25/2015
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