Provider Demographics
NPI:1649383076
Name:MABEY, MARIANNE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:
Last Name:MABEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1552 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-1710
Mailing Address - Country:US
Mailing Address - Phone:801-583-2711
Mailing Address - Fax:
Practice Address - Street 1:220 MILLPOND STE 100
Practice Address - Street 2:
Practice Address - City:STANSBURY PARK
Practice Address - State:UT
Practice Address - Zip Code:84074-9760
Practice Address - Country:US
Practice Address - Phone:435-843-3052
Practice Address - Fax:435-843-3055
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5034471-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist