Provider Demographics
NPI:1275505927
Name:MARLIN, AMY (ATC, L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MARLIN
Suffix:
Gender:F
Credentials:ATC, L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:769 VILLA FLORES DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1526
Mailing Address - Country:US
Mailing Address - Phone:915-842-0828
Mailing Address - Fax:915-771-6914
Practice Address - Street 1:7800 EDGEMERE BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3835
Practice Address - Country:US
Practice Address - Phone:915-780-1109
Practice Address - Fax:915-771-6914
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT2716174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist