Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PS008894L | PA |
NPI | 1053331298 |
---|---|
Provider Name | Dr. Tod R Marion |
First Address | Beaver, PA 15009 |
Second Address | Beaver, PA 15009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 27/03/2016 |