Provider Demographics
NPI:1629194758
Name:AXTON, ROSEMARIE MUIR (MFT)
Entity type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:MUIR
Last Name:AXTON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:ROSEMARIE
Other - Middle Name:MUIR
Other - Last Name:AXTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:1270 NATIVIDAD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3122
Mailing Address - Country:US
Mailing Address - Phone:831-657-1360
Mailing Address - Fax:831-657-1378
Practice Address - Street 1:2150 GARDEN RD
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5327
Practice Address - Country:US
Practice Address - Phone:831-657-1360
Practice Address - Fax:831-657-1378
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT16154106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist