Provider Demographics
NPI:1063673770
Name:PALMER, MARILYN COURTNAY (LMFT, RPT)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:COURTNAY
Last Name:PALMER
Suffix:
Gender:F
Credentials:LMFT, RPT
Other - Prefix:MISS
Other - First Name:MARILYN
Other - Middle Name:COURTNAY
Other - Last Name:YEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2359 EVERLEY CIR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8843
Mailing Address - Country:US
Mailing Address - Phone:916-224-6892
Mailing Address - Fax:916-781-0196
Practice Address - Street 1:2359 EVERLEY CIR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-8843
Practice Address - Country:US
Practice Address - Phone:916-224-6892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC# 37471106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist