Provider Demographics
NPI:1851993547
Name:HARO, MARCELLA VIRGEN (LMFT)
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:VIRGEN
Last Name:HARO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 S GRAMERCY PL APT 8
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-3458
Mailing Address - Country:US
Mailing Address - Phone:213-842-4094
Mailing Address - Fax:
Practice Address - Street 1:839 S GRAMERCY PL APT 8
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-3458
Practice Address - Country:US
Practice Address - Phone:213-842-4094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122922106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist