Provider Demographics
NPI:1437435005
Name:COEN, MARJORIE MARIE
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:MARIE
Last Name:COEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 JACK LITTLE DR
Mailing Address - Street 2:APT D5
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-7798
Mailing Address - Country:US
Mailing Address - Phone:520-591-8808
Mailing Address - Fax:
Practice Address - Street 1:107 JACK LITTLE DR
Practice Address - Street 2:APT. D5
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-7798
Practice Address - Country:US
Practice Address - Phone:520-591-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist