Provider Demographics
NPI:1558479014
Name:MACKEL, MARILYN
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:
Last Name:MACKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:
Other - Last Name:MABRY-WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8208 CENTER PKWY APT 13
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5390
Mailing Address - Country:US
Mailing Address - Phone:916-361-2089
Mailing Address - Fax:
Practice Address - Street 1:2801 ARAMON DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-4803
Practice Address - Country:US
Practice Address - Phone:916-361-2089
Practice Address - Fax:916-361-2091
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor