Marlene M Peterson, LCSW

Individual provider Active NPI Clinical Social Worker · Pointblank, TX

NPI 1861675902 · NPPES record last updated Apr 28, 2009

Key facts

NPI
1861675902
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
12401 (TX)
Practice address
9951 US Highway 190 E
Pointblank, TX 77364-6896
Phone
(281) 851-1685
NPI assigned
Dec 12, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
12401TXMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12401 TX Yes

Addresses

Primary practice location

9951 US Highway 190 E
Pointblank, TX 77364-6896

Mailing address

9951 US Highway 190 E
Pointblank, TX 77364-6896
Phone (281) 851-1685

Other providers in Pointblank, TX

All providers in Pointblank, TX · Clinical Social Worker in Texas

Sources for this page

Verify at the official NPI Registry.