Provider Demographics
NPI:1790373470
Name:MARZWELL, CAROLINE EMILY (AMFT)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:EMILY
Last Name:MARZWELL
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11502 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5412
Mailing Address - Country:US
Mailing Address - Phone:917-572-7927
Mailing Address - Fax:
Practice Address - Street 1:11502 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5412
Practice Address - Country:US
Practice Address - Phone:917-572-7927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11635106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist