Provider Demographics
NPI:1497114995
Name:MARION, SAMONE RENEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMONE
Middle Name:RENEE
Last Name:MARION
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:22511 TELEGRAPH RD STE 215
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-4108
Mailing Address - Country:US
Mailing Address - Phone:248-809-2051
Mailing Address - Fax:313-731-1857
Practice Address - Street 1:22511 TELEGRAPH RD STE 215
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-4108
Practice Address - Country:US
Practice Address - Phone:248-809-2051
Practice Address - Fax:248-996-8384
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional