Individual
MARISA MARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1255 W BASELINE RD STE B258, MESA, AZ 85202-5820
(480) 284-3271
Mailing address
4150 E SIERRA MADRE AVE, GILBERT, AZ 85296-3084
(480) 284-3271
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-15935
AZ
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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