Provider Demographics
NPI:1275983942
Name:APPLEGATE, MARIN A (SCHOOL PSYCH, NCSP)
Entity Type:Individual
Prefix:MRS
First Name:MARIN
Middle Name:A
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:SCHOOL PSYCH, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 BOND RD
Mailing Address - Street 2:
Mailing Address - City:MINFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45653-8988
Mailing Address - Country:US
Mailing Address - Phone:740-820-3007
Mailing Address - Fax:740-820-2466
Practice Address - Street 1:491 BOND RD
Practice Address - Street 2:
Practice Address - City:MINFORD
Practice Address - State:OH
Practice Address - Zip Code:45653-8988
Practice Address - Country:US
Practice Address - Phone:740-820-3007
Practice Address - Fax:740-820-2466
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1371502174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist