Provider Demographics
NPI:1932559424
Name:HOELLER, MARION
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:HOELLER
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 1:1375 VILLAGE WAY APT H
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5375
Mailing Address - Country:US
Mailing Address - Phone:916-719-8819
Mailing Address - Fax:
Practice Address - Street 1:1375 VILLAGE WAY APT H
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5375
Practice Address - Country:US
Practice Address - Phone:916-719-8819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator