Provider Demographics
NPI:1811735764
Name:MARNEE REILEY, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Entity type:Organization
Organization Name:MARNEE REILEY, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARNEE
Authorized Official - Middle Name:
Authorized Official - Last Name:REILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-648-7991
Mailing Address - Street 1:17682 MITCHELL N STE 104
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6094
Mailing Address - Country:US
Mailing Address - Phone:949-648-7991
Mailing Address - Fax:
Practice Address - Street 1:17682 MITCHELL N STE 104
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6094
Practice Address - Country:US
Practice Address - Phone:949-648-7991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health