Doctor Name: | MS. JEAN ANDREWS MARESCH |
NPI Number: | 1265645758 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 14597 |
Business Practice Address: | 1165 E Main St Alice, TX - 783325046 |
Business Phone Number: | 3616649587 |
Business Fax Number: | 3617770610 |
Mailing Address: | 200 Marriott Dr, PORTLAND |
State: | TX |
Postal Code: | 783742213 |
Phone Number: | 3617773991 |
Fax Number: | 3617770610 |
NPI Enumeration Date: | 05/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 14597 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |