Provider Demographics
NPI:1821334285
Name:VILCA-PAUL, MARLENI (LMFTA)
Entity Type:Individual
Prefix:
First Name:MARLENI
Middle Name:
Last Name:VILCA-PAUL
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 TWISTING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9818
Mailing Address - Country:US
Mailing Address - Phone:252-412-4829
Mailing Address - Fax:
Practice Address - Street 1:1157 TWISTING CREEK RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-9818
Practice Address - Country:US
Practice Address - Phone:252-412-4829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8070A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist