Provider Demographics
NPI:1356455679
Name:HARROWER, MARILYN LEE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:LEE
Last Name:HARROWER
Suffix:
Gender:F
Credentials:MFT
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 77
Mailing Address - Street 2:
Mailing Address - City:MOUNT HERMON
Mailing Address - State:CA
Mailing Address - Zip Code:95041
Mailing Address - Country:US
Mailing Address - Phone:831-335-0895
Mailing Address - Fax:831-335-3934
Practice Address - Street 1:5437 SCOTTS VALLEY DR
Practice Address - Street 2:STE D
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066
Practice Address - Country:US
Practice Address - Phone:831-335-0895
Practice Address - Fax:831-335-3934
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT28462106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist