Provider Demographics
NPI:1821499252
Name:MARRS, JOANNE MARIE (MA, MFTI)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:MARIE
Last Name:MARRS
Suffix:
Gender:F
Credentials:MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 E THOMPSON BLVD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-2918
Mailing Address - Country:US
Mailing Address - Phone:805-643-1446
Mailing Address - Fax:805-764-9480
Practice Address - Street 1:856 E THOMPSON BLVD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2918
Practice Address - Country:US
Practice Address - Phone:805-643-1446
Practice Address - Fax:805-764-9480
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63927106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist