Provider Demographics
NPI:1841755634
Name:CUEVAS, MARLYNE
Entity Type:Individual
Prefix:
First Name:MARLYNE
Middle Name:
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-7320
Mailing Address - Country:US
Mailing Address - Phone:498-461-5564
Mailing Address - Fax:
Practice Address - Street 1:505 E COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-4009
Practice Address - Country:US
Practice Address - Phone:714-773-0077
Practice Address - Fax:714-773-0067
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician