Provider Demographics
NPI:1487217501
Name:MARILYN R. GRIFFIN, MARRIAGE FAMILY THERAPY, P.C.
Entity Type:Organization
Organization Name:MARILYN R. GRIFFIN, MARRIAGE FAMILY THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:916-287-0227
Mailing Address - Street 1:2330 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7781
Mailing Address - Country:US
Mailing Address - Phone:916-287-0227
Mailing Address - Fax:916-781-6974
Practice Address - Street 1:2330 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-7781
Practice Address - Country:US
Practice Address - Phone:916-287-0227
Practice Address - Fax:916-781-6974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health