Basic Information
| Provider Information | |||||||||
| NPI: | 1457028813 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARLOW | ||||||||
| FirstName: | HAYLEY | ||||||||
| MiddleName: | RENEE | ||||||||
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| Credential: | M.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20013 BLACKBURN ST | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480801051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3134188928 | ||||||||
| FaxNumber: | 5862793886 | ||||||||
| Practice Location | |||||||||
| Address1: | 23100 JEFFERSON AVE | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480802756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5863352006 | ||||||||
| FaxNumber: | 5862793886 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2021 | ||||||||
| LastUpdateDate: | 05/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.