Provider Demographics
NPI:1821198300
Name:BATHEN, MARILYN MAUREEN (DRUG AND ALCOHOL)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:MAUREEN
Last Name:BATHEN
Suffix:
Gender:F
Credentials:DRUG AND ALCOHOL
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:MAUREEN
Other - Last Name:TURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CATC III
Mailing Address - Street 1:714 N ANAHEIM BLVD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2651
Mailing Address - Country:US
Mailing Address - Phone:714-776-6090
Mailing Address - Fax:
Practice Address - Street 1:714 N ANAHEIM BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-2651
Practice Address - Country:US
Practice Address - Phone:714-776-6090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)