Provider Demographics
NPI:1336530831
Name:MARRERO, EMMA (MHS)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 KIDSPEACE DR
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-2044
Mailing Address - Country:US
Mailing Address - Phone:610-776-5465
Mailing Address - Fax:610-663-3270
Practice Address - Street 1:5300 KIDSPEACE DR
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069-2044
Practice Address - Country:US
Practice Address - Phone:610-776-5465
Practice Address - Fax:610-663-3270
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health