Provider Demographics
NPI:1710128897
Name:OAKES, MARILYN RYAN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:RYAN
Last Name:OAKES
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110A BOCA RATON DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-1669
Mailing Address - Country:US
Mailing Address - Phone:512-461-9244
Mailing Address - Fax:512-371-9706
Practice Address - Street 1:2110A BOCA RATON DR
Practice Address - Street 2:SUITE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78747-1669
Practice Address - Country:US
Practice Address - Phone:512-461-9244
Practice Address - Fax:512-371-9706
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional