Provider Demographics
NPI:1437666260
Name:MARULL, LOUIS ALEXANDER
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:ALEXANDER
Last Name:MARULL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15704 TRADITIONS DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1149
Mailing Address - Country:US
Mailing Address - Phone:405-657-7433
Mailing Address - Fax:
Practice Address - Street 1:15704 TRADITIONS DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1149
Practice Address - Country:US
Practice Address - Phone:405-657-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor