Doctor Name: | JODI MARR |
NPI Number: | 1003033218 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | AA |
License Number: | |
Business Practice Address: | 2501 W Shaw Ave Ste 101 Fresno, CA - 937113307 |
Business Phone Number: | 5592211680 |
Business Fax Number: | 5592214336 |
Mailing Address: | 2501 W Shaw Ave Ste 101, FRESNO |
State: | CA |
Postal Code: | 937113307 |
Phone Number: | 5592211680 |
Fax Number: | 5592214336 |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |