Provider Demographics
NPI:1952098485
Name:MUEGGE, MARIAN ELEN (AMFT)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:ELEN
Last Name:MUEGGE
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 R ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-2550
Mailing Address - Country:US
Mailing Address - Phone:530-768-6837
Mailing Address - Fax:
Practice Address - Street 1:12755 W END RD
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-8956
Practice Address - Country:US
Practice Address - Phone:707-845-8737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT125464106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist