Provider Demographics
NPI:1790034353
Name:DIANNE S MARLON LTD
Entity Type:Organization
Organization Name:DIANNE S MARLON LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-533-7324
Mailing Address - Street 1:2016 CASA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-2985
Mailing Address - Country:US
Mailing Address - Phone:702-533-7324
Mailing Address - Fax:702-876-0917
Practice Address - Street 1:2975 S RAINBOW BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6242
Practice Address - Country:US
Practice Address - Phone:702-533-7324
Practice Address - Fax:702-493-1643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6166-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty