Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1245817360 |
---|---|
Provider Name | Marnie Suzanne King |
First Address | Valencia, CA 91355-4990 |
Second Address | Valencia, CA 91355-4990 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2021 |
Last Update Date | 25/03/2021 |