Provider Demographics
NPI:1811285760
Name:MARLOW, DEZI A
Entity type:Individual
Prefix:
First Name:DEZI
Middle Name:A
Last Name:MARLOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3867 MEDINA RD STE 213
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4525
Mailing Address - Country:US
Mailing Address - Phone:216-452-8808
Mailing Address - Fax:
Practice Address - Street 1:3867 MEDINA RD STE 213
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-4525
Practice Address - Country:US
Practice Address - Phone:216-452-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OHC.1100249-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health