Provider Demographics
NPI:1841858552
Name:MARION, NADJA MICHELLE
Entity type:Individual
Prefix:MRS
First Name:NADJA
Middle Name:MICHELLE
Last Name:MARION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 RHONDA CIR E
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4325
Mailing Address - Country:US
Mailing Address - Phone:901-690-0327
Mailing Address - Fax:
Practice Address - Street 1:213 RHONDA CIR E
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4325
Practice Address - Country:US
Practice Address - Phone:901-690-0327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1558927111Medicaid