Provider Demographics
NPI:1912130725
Name:FARRELL, MARINAH VALENZUELA (CPM, LM)
Entity Type:Individual
Prefix:
First Name:MARINAH
Middle Name:VALENZUELA
Last Name:FARRELL
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 N 106TH DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85307-4014
Mailing Address - Country:US
Mailing Address - Phone:602-793-5063
Mailing Address - Fax:866-307-7690
Practice Address - Street 1:5315 N 106TH DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85307-4014
Practice Address - Country:US
Practice Address - Phone:602-793-5063
Practice Address - Fax:866-307-7690
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2016-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM143176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife