Provider Demographics
NPI:1215226550
Name:SCARROW, MARCIE (MS)
Entity Type:Individual
Prefix:MS
First Name:MARCIE
Middle Name:
Last Name:SCARROW
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5263
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83303-5263
Mailing Address - Country:US
Mailing Address - Phone:208-948-5031
Mailing Address - Fax:
Practice Address - Street 1:1201 FALLS AVE E
Practice Address - Street 2:SUITE 25
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3405
Practice Address - Country:US
Practice Address - Phone:208-948-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-4485101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional