Basic Information
| Provider Information | |||||||||
| NPI: | 1477889368 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOWNER | ||||||||
| FirstName: | MARILYNN | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | MA, LMFT-I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7001 W CHARLESTON BLVD APT 2044 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891171658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024166465 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2820 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE C-23 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024374673 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2009 | ||||||||
| LastUpdateDate: | 10/27/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | M10133 | NV | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.