1447294327 NPI number — MS. MERILYN HOWTON MARRIOTT M.S., LPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447294327 NPI number — MS. MERILYN HOWTON MARRIOTT M.S., LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARRIOTT
Provider First Name:
MERILYN
Provider Middle Name:
HOWTON
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOWTON
Provider Other First Name:
MERILYN
Provider Other Middle Name:
FAYE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., LPC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1447294327
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1342
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIDOR
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77670-1342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-769-1824
Provider Business Mailing Address Fax Number:
409-769-1829

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
157 LOWE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VIDOR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77662-3844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-769-1824
Provider Business Practice Location Address Fax Number:
409-769-1829
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  12030 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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