Individual
MS. MARIENA STAR JOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
137 HALL AVE, COOS BAY, OR 97420-1519
(541) 229-7879
Mailing address
137 HALL AVE, COOS BAY, OR 97420-1519
(541) 229-7879
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L10767
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500740402
—
OR
Enumeration date
01/13/2016
Last updated
12/02/2023
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