Provider Demographics
NPI:1700237690
Name:MARDEN, MARLAINE
Entity Type:Individual
Prefix:
First Name:MARLAINE
Middle Name:
Last Name:MARDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3137
Mailing Address - Country:US
Mailing Address - Phone:775-623-1888
Mailing Address - Fax:775-623-6495
Practice Address - Street 1:35 W 1ST ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3137
Practice Address - Country:US
Practice Address - Phone:775-623-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor